Coding Specialist, Pre-Service

ESSENTIAL FUNCTIONS

• Reviewing patient records, doctor's notes, and other relevant documentation to extract information about diagnoses, procedures, and treatments.


• Determine which diagnostic and procedural information is necessary for accurate coding of an authorization.


• Assign appropriate ICD-10, CPT, and HCPCS codes based on the information found in the medical records.


• Verifying the correctness of assigned codes, ensuring they align with coding guidelines and regulations, and identifying any discrepancies or errors.


• Communicating with physicians, clinical stakeholders and other teams such as surgical scheduling and authorization management to clarify any ambiguities in the documentation or coding.


• Ensuring the security and confidentiality of patient information as mandated by HIPAA. 

EDUCATION

• High School Diploma/GED

EXPERIENCE

• 2-3 years of experience in coding and medical terminology


• Ortho coding is required


• Must be AAPC/AHIMA/NHA Certified with maintained credentials

REQUIREMENTS

• Coding Certification from AAPC/AHIMA/NHA (CPC, CCS-P, CBCS)

KNOWLEDGE

• Knowledge of medical terminology


• In-depth knowledge of coding guidelines and regulations

SKILLS

•  The ability to identify and resolve discrepancies in medical records or claims. 


•  Accuracy is critical in coding, requiring meticulous attention to detail. 


•  The ability to communicate effectively with physicians and other healthcare professionals. 


• Efficiently inputting and managing coding data. 

ABILITIES

• Ability to be a resource for coding guidelines.


• Ability to communicate effectively verbally and in writing.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.


• Some bending and stretching are required.


• Manual dexterity using a calculator and computer keyboard

ORGANIZATIONAL REQUIREMENTS

• HOPCo Mission, Vision, and Values must be read and signed.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.