Coding Compliance Specialist - Health Information - INTEGRIS
Company: INTEGRIS Health
Location: Oklahoma City
Posted on: April 8, 2021
Coding and Comp Specialist
Job Code: 1036
The Coding Compliance Consultant analyzes relevant clinical and
demographic information from the Health Information record, audits
for appropriate ICD-9-CM and/or ICD-10 and CPT/HCPCS code
assignment following appropriate guidelines and ascertains that the
above are compliant with OIG, HCFA, JCAHO, Medicare, state and
other regulatory agencies.
All applicants will receive consideration regardless of membership
in any protected status as defined by applicable state or federal
law, including protected veteran or disability status. INTEGRIS
Health is an Equal Opportunity/Affirmative Action Employer.
The Coding Compliance Consultant responsibilities include, but are
not limited to, the following:
* Reviews commercial and governmental coding denials and initiates
the appeal process, when applicable, working closely with the
denials management team.
* Reviews coding compliance concerns as related to National
Coverage Determinations and Local Coverage Determinations and
initiates staff education on such matters as necessary.
* Performs quality assurance and training audits to support coding
* Provides on-going training and education to coding staff.
* Reports statistics concerning coding accuracy levels.
* Assigns codes proficiently and analyzes documentation for
appropriate severity of illness and risk of mortality
* Completes analysis of documentation, abstracting and code
assignment by body system, organ, etiology and morphology according
to the American Hospital Association Official ICD-10 Coding
Guidelines (Coding Clinic), CPT4/HCPCS Coding Guidelines, ASC
groups, UHDDS Guidelines, HCFA methodology guidelines for coding,
state and federal guidelines and hospital abstracting
* Coordinates documentation needs with CDI Team, including
initiation of query process, query follow-up and final DRG
* Performs data analytics to mine for coding and documentation
opportunities, performs gap analysis, and puts performance
improvement initiatives into place.
Reports to the System Manager Clinical Coding.
Required Physical Demands (Subject to Reasonable
Keyboarding/Dexterity: Frequently; activity exists from 1/3 to 2/3
of the time
Standing/Walking: Occasionally; activity exists up to 1/3 of the
Strength (Lift/Carry/Push/Pull): Sedentary (exerting up to 10
pounds of force occasionally)
Talking (Must be able to effectively communicate verbally): Yes
Color Acuity (Must be able to distinguish and identify colors):
This position may have additional or varied physical demand and/or
respiratory fit test requirements. Please consult the Physical
Demands Project SharePoint site or contact Risk Management/Employee
Health for additional information.
Hazards are minimal if safety precautions are utilized. Heavy work
volume, high degree of accuracy required and stringent deadlines.
Exposure to serious error is present: data integrity, health
information security /confidentially. May be required to work
extended hours, on off shifts and weekends/holidays related to
deadlines and needs of System departments. Travel may be required
to INTEGRIS facilities. Exposure to weather conditions during
* Knowledge of medical terminology, anatomy and physiology, coding
* Knowledge of various computer applications including Windows,
Excel, hospital information systems and encoders
* One of the following:
* CCS: Certified Coding Specialist Certification and three years of
* CPC: Certified Professional Coder and three years of coding
* RHIT: Registered Heath Information Technologist Certification.
Requires Associate Degree and two years of coding experience
* RHIA: Registered Health Information Administrator Certification.
Requires Bachelor Degree and one year of coding experience
* Must be able to communicate effectively in English
Keywords: INTEGRIS Health, Oklahoma City , Coding Compliance Specialist - Health Information - INTEGRIS, Healthcare , Oklahoma City, Oklahoma
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