Clinical & Coding Specialist - Senior responsible for reviewing coding and clinical decisions for complex cases. Supporting team training and audit processes at Independent Health in Buffalo, NY.
About the role
- Health Information Management position at Connecticut Children’s applying diagnostic codes for inpatient claims processing and data quality. Requires residency in CT, MA, or NY or willingness to relocate.
Responsibilities
- Apply the appropriate diagnostic and procedural codes to individual health information for data retrieval, analysis, and claims processing.
- Create consistency and efficiency in inpatient claims processing and data collection to optimize DRG reimbursement and facilitate data quality in hospital inpatient services.
Requirements
- Education Required: Associate's degree or equivalent training acquired through at least three years on-the-job experience.
- Experience Preferred: Successful completion of a coding certificate program with AHIMA approval status preferred.
- Certification is required within one year of hire; acceptable certifications for this position include:
- American Health Information Management Association (AHIMA): RHIA, RHIT, CCS, CCS-P, CCA
- American Academy of Professional Coders (AAPC).
- Knowledge of coding guidelines for using ICD-9-CM (Volumes 1, 2, and 3), ICD-10-CM, ICD-10-PCS, CPT and HCPCS Level II codes in inpatient and outpatient settings.
- Extensive knowledge of anatomy and medical terminology.
- Maintains, and increases knowledge of issues that affect coding and billing and the healthcare industry.
- Regulatory requirements pertaining to healthcare operations in the practice and hospital settings.
- Advanced Computer skills, PC experience w/ Windows-based applications.
- Keyboarding skills with ability to type 40 wpm minimum.
- Analyze complex medical records and identify billable services.
- Work with individuals at all levels within the organization and the community; effectively communicate with providers.
- Manage and prioritize workloads to meet deadlines.
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development opportunities
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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