Clinical Coding Specialist II
The Miriam Hospital - Providence, RI

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Description : Reports to the Coding Manager. Reviews the outpatient clinical documentation of extract data and assign appropriate ICD-9-CM and CPT codes in accordance with the outpatient ICD-9-CM Official Guidelines for Coding and Reporting and the AHA HCPCS Coding Clinics. Reviews the medical records to ensure the documentation supports the code assignment. Utilizes 3M APC Finder for code assignment and appropriate resolutions of claim edits (CCI, NCD, OCE, etc.) Confer with physician for clarification as needed. Monitors outpatient uncoded report to ensure timely coding and billing process. Maintains and meets HIS quality and productivity standards.
Qualifications : BASIC KNOWLEDGE: High school diploma or equivalent. Successful completion of formal coding educational program. Ability to read and understand outpatient clinic medical record documentation for reporting of outpatient clinic, ancillary and endoscopies. Coding certification required from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC). EXPERIENCE: One to two years experience in outpatient coding or billing. Ability to meet and maintain established quality and productivity standards.