REVENUE OPERATIONS & CODING POSITION DESCRIPTION

Position Title: Sr. Clinical Coding Specialist - Surgery

Department: Revenue Operations & Coding

Division: Finance

Reports to: Supervisor, Clinical Coding

MISSION STATEMENT

The mission of The University of Texas M.D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.

SUMMARY:

The primary purpose of the Sr. Clinical Coding Specialist position is to analyze complex medical records and abstract clinical data by assigning codes from patient records in accordance with coding classification systems.

The following will apply to a position hired for the Interventional Radiology (IR) coder:

· Matrix relationship to Revenue Operations & Coding, Supervisor and IR, Associate Director.

· Split time and shared oversight with IR

· CIRCC certification through the American Academy of Professional coders

· Training and quality oversight of the IR technologist

· Routine quality review reports

KEY FUNCTIONS:

1. Analyzes complex medical records to abstract clinical data by assigning codes from patient records in accordance with the coding classification systems of ICD-10-CM and/or CPT.

2. Reviews patient encounters for accurate code assignment(s) of all relevant diagnosis, procedures and/or modifiers.

3. Applies guidelines as indicated through the Local Coverage Determination (LCD), National Coverage Determination (NCD), as well as the National Correct Coding Initiative (CCI).

4. Coder meets and maintains a production rate of 90% or higher.

5. Coder meets and maintains an accuracy rate of 90% on all coded records.

6. Queries physicians and/or departments when code assignments are not straightforward or if documentation in the record is inadequate, ambiguous or unclear for coding purposes.

7. Maintains coding knowledge and skills through attending continuing education activities and reviewing pertinent literature, attending institutional coding meetings, seminars, and other educational forums.

8. Identifies and reports documentation issues and may participate in team or provider educational activities.

9. Communicates effectively and demonstrates good interpersonal and professional skills when interacting with others.

10. May be required to attend/participate in group, or individual meetings with providers of service, or with administration.

11. May collect and prepare data for management review.

12. Serves as a resource concerning clinical coding practice, policies and procedures.

13. Report problems/concerns to management proactively for continuous process improvement.

14. Review and provide resolution of edits/warnings.

15. Resolves claim and billing edits as well as denials by performing second review of medical record documentation and code assignments.

16. Other duties, as assigned.

WORK CONDITIONS:

This position requires:

Working in Office Environment _ No _X Yes

Working in Patient Care Unit (e.g. nursing

Unit; outpatient clinic) X_ No __ Yes

Exposure to human/animal blood,

Body fluids, or tissues X No __ Yes

Exposure to harmful chemicals _ X_ No __ Yes

Exposure to radiation _ X_ No __ Yes

Exposure to animal's _ X_ No __ Yes

PHYSICAL DEMANDS

Indicate the time required to do each of the following physical demands:

Time Spent

Never

0%

Occasionally

1-33%

Frequently

34-66%

Continuously

67-100%

Standing

X

Walking

X

Sitting

X

Reaching

X

Lifting/Carrying

Up to 10 lbs

X

10lbs to 50 lbs

X

More than 50 lbs

X

Pushing/Pulling

Up to 10 lbs

X

10lbs to 50 lbs

X

More than 50 lbs

X

Use computer/keyboard

X

Required Education:

Associate's degree in Health Information Management, Healthcare Administration, or related healthcare field.

Preferred Education:

Bachelor's degree in Health Information Management, Healthcare Administration, or related healthcare field.

Required Experience:

Five years of clinical coding experience for complex or multi-specialties. With preferred degree, three years of clinical coding experience for complex or multi-specialties. May substitute required education degree with additional years of equivalent experience on a one to one basis.

Preferred Experience:

Surgery coding experience.

Required Certifications/Licenses:

One or more of the following:

Registered Health Information Administrator (RHIA) by the American Health Information Management Association (AHIMA).

Registered Health Information Technician (RHIT) by the American Health Information Management Association (AHIMA).

Certified Coding Specialist (CCS) by the American Health Information Management Association (AHIMA).

Certified Coding Associate (CCA) by the American Health Information Management Association (AHIMA).

Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC).

Certified Professional Coder - Associate (CPC-A) by the American Academy of Professional Coders (AAPC).

Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC).

Other Requirements:

Must pass pre-employment skills test as required and administered by Human Resources.

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html

Additional Information

• Requisition ID: 169683

• Employment Status: Full-Time

• Employee Status: Regular

• Work Week: Days

• Minimum Salary: US Dollar (USD) 65,000

• Midpoint Salary: US Dollar (USD) 81,000

• Maximum Salary : US Dollar (USD) 97,000

• FLSA: non-exempt and eligible for overtime pay

• Fund Type: Hard

• Work Location: Remote (within Texas only)

• Pivotal Position: Yes

• Referral Bonus Available?: No

• Relocation Assistance Available?: No

• Science Jobs: No

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