Overview
Accurately and efficiently code records using ICD-10 and CPT codes to obtain the most accurate data based on
documentation. Monitors, researchers, and corrects claim denials due to coding issues. Complies with all
Federal and State standards for health data submissions to prevent fraud and abuse. Facilitates optimal
reimbursement.
Reports to: Market Director – Physician Practices and Billing Coordinator
FLSA: Non-exempt
Grade: 219
EEO: â–¡ 01 Officials and Managers â–¡ 02 Professionals â–¡ 03 Technicians â–¡ 04 Sales Workers X 05 Administrative
Support Workers â–¡ 06 Craft Workers â–¡ 07 Operatives â–¡ 08 Laborers and Helpers â–¡ 09 Service Workers
Assigns accurate ICD diagnosis codes, using compliant documentation.
Assigns accurate CPT/HCPCS codes to records, using compliant documentation.
Applies knowledge of Coding Guidelines to select the appropriate diagnosis code.
Uses available research and reference tools to understand the disease process and diagnosis.
Interprets physician documentation within the coding guidelines and obtains clarification from physicians
regarding vague or ambiguous record documentation.
Enhances coding knowledge and skills with continuing education activities as described in HIM.COD.003 policy
and by reviewing pertinent literature.
Cross train other specialties include but not limited to Orthopedics, Peds, OBGYN, Internal Medicine,
Gastroenterology, Endocrinology, General Surgery, Urology, Rheumatology, Pulmonary, Anesthesia, ENT,
Radiology, General Surgery,
Monitor, research and correct claim denials within health plan requirements and document any trends with
which to follow-up
Complies with Federal and State standards utilizing CCI edits, Medicare bulletins, ACR bulletins, etc. to keep
abreast of the changes within the industry.
Minimum Education:
High School diploma – Required. Associate of Science degree in Health Information Technology or a Bachelor
of Science degree in Health Information Management or other Medical Coding education -Preferred.
Associate’s or Bachelor’s degree required after 9/30/2002 if credentialed through AHIMA (formerly ART)
Required Skills:
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be
able to work in a stressful environment and take appropriate action.
Must have thorough understanding of ICD-10 Official Coding Guidelines for Coding and Reporting and AHA
Coding Clinic; HCPCS/CPT coding systems and CPT Assistant and Coding Clinic for HCPCS guidelines; Medicare
Outpatient Prospective Payment System (OPPS), and Ambulatory Payment Classification (APC).
Has knowledge of and abides by HIM.COD policies.
Licenses: RHIA, RHIT, RT, AART, CPC, CCS, CCSP, OR other related certification – Required to be obtained within
6 months of employment, if not current upon hire.
Associate’s or Bachelor’s degree required after 9/30/2002 if credentialed through AHIMA (formerly ART)
Minimum Work Experience:
If certified upon hire – Two (2) years experience within a physician office or other outpatient setting with
emphasis on ICD-9-CM, ICD-10, CPT coding and the prospective payment system – Required
If not certified upon hire – Five (5) years experience as required above – Required
**Job:** **Health Information Management/Coding*
**Organization:** **HighPoint – Sumner Physicians Practice*
**Title:** *Coding Specialist- Remote Work Opportunity*
**Location:** *Tennessee-Gallatin*
**Requisition ID:** *7457-11927*
