Job Description
Job Description We’re searching for a Coding Quality Assurance Specialist I -- someone who works well in a fast-paced setting. In this position, you will assign and audit the accuracy of the ICD-10-CM and CPT codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory agencies. The position also ascertains the accuracy of the physicians' E/M and procedure coding, completes the auditing reporting tool, and provides this feedback to the education team and/or provider. Think you’ve got what it takes? Job Duties & Responsibilities Assigns ICD-10-CM and CPT codes. Reviews documentation in records to appropriately assign ICD-10-CM, PCS, and CPT codes. Communicates with and provides feedback to the education team and/or provider. Utilizes the encoder or coding books to correctly assign all appropriate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures. Sequences diagnosis and procedures to generate appropriate DRGs for billing in accordance with the Coding Guidelines based on the type of coding. Queries physicians to obtain clarification or missing elements in the record preventing correct coding. Utilizes available resources for assignment of codes as necessary (e.g., Diagnostic Imaging system, Lab system, Emergency Center system, Cardiac Cath system, Epic, and coding reference books). Inputs codes into the Epic computer system utilizing the Encoder. Completes abstracts if appropriate. Identifies problem accounts. Assists in correction of problem accounts. Participates in education and maintains certification. Maintains concurrent coding for all records. Skills & Requirements Required H.S. Diploma or GED Required Certifications LCCA - Certified Coding Associate CCS - Cert-Cert Coding Specialist CCS-P - Cert-CCS-P Physician Based CIPC - Certified Inpatient Coder COC - Certified Outpatient Coder COC-A - Cert Outpat Coder - Apprentice CPC - Cert-Cert Professional Coder CPC-A - Cert Prof Coder - Apprentice CRC - Cert Risk Adjustment Coder RHIA - Cert-Reg Health Infm. Admins RHIT - Cert-Reg Health Infm. TECH Required 1 Years’ Experience As a Coder ABOUT US Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S. News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years. Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research Texas Children ’ s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births Texas Children ’ s Hospital West Campus, a community hospital in suburban West Houston Texas Children ’ s Hospital The Woodlands, the first hospital devoted to children ’ s care for communities north of Houston; and Texas Children’s Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children ’ s Health Plan, the nation ’ s first HMO focused on children Texas Children ’ s Pediatrics, the largest pediatric primary care network in the country Texas Children ’ s Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children ’ s Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation. To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of