Medical Coding Specialist II – Anesthesia/Pain Coder

Responsibilities

• Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes.
• Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD) directives, Medically Unlikely Edits (MUEs), and Medicare Teaching Physician Guidelines, applying knowledge of applicable regulatory requirements and institutional guidelines to select appropriate codes and modifiers.

Requirements

• High School Diploma or equivalent and medical coding education.
• In lieu of a medical coding education, an active coding certification.
• Associate's Degree in a healthcare related field – Preferred.
• 1 year of progressive coding experience (For HCC-specific roles, experience must be specific to HCC).
• 2 years progressive coding experience in multiple specialties, HCC Risk adjustment Coding – Preferred.
• Certified Professional Coder (CPC) Upon Hire Required or Certified Outpatient Coder (COC) Upon Hire Required or Certified Inpatient Coder (CIC) Upon Hire Required or Certified Coding Specialist (CCS) Upon Hire Required or Certified Coding Specialist Physician-Based (CCS-P) Upon Hire Required or Certified Coding Associate (CCA) Upon Hire Required or Certified Risk Adjustment Coder (CRC) Upon Hire Required or Registered Health Information Technician (RHIT) Upon Hire Required or Registered Health Information Administrator (RHIA) Upon Hire Required.
• Registered Health Information Technician (RHIT) Preferred or Registered Health Information Administrator (RHIA) Preferred.

Hard Skills

• ICD-10-CM coding
• CPT coding
• HCPCS coding
• Evaluation and Management (E&M) coding
• coding resources utilization
• coding compliance
• coding guidelines application
• regulatory requirements knowledge
• coding experience
• HCC Risk adjustment coding

Certifications & Qualifications

• Certified Professional Coder (CPC)
• Certified Outpatient Coder (COC)
• Certified Inpatient Coder (CIC)
• Certified Coding Specialist (CCS)
• Certified Coding Specialist Physician-Based (CCS-P)
• Certified Coding Associate (CCA)
• Certified Risk Adjustment Coder (CRC)
• Registered Health Information Technician (RHIT)
• Registered Health Information Administrator (RHIA)

Industry Keywords

• National Correct Coding Initiatives (NCCI)
• Local Coverage Documents (LCD)
• National Coverage Documents (NCD)
• Medically Unlikely Edits (MUEs)
• Medicare Teaching Physician Guidelines

Tools & Technologies

• encoder software
• grouper software