Responsibilities:

• Assist in monitoring and analyzing policies and procedures to organize and implement an accurate and efficient International Classification of Diseases (ICD) policy and system support program.

• Serve as a medical policy resource, analyst, and technical expert advisor for ICD, CPT, and HCPCS coding systems; incorporate relevant ICD, CPT, and HCPCS policy and guidelines on a statewide basis.

• Monitor and analyze ICD reports generated on agency systems for appropriate usage and assignment of ICD codes; assist the ICD program manager with identification of applicable regulations and policies while maintaining high standards of accuracy and efficiency.

• Collaborate as needed to resolve coding discrepancies related to CPT and HCPCS coding.

Knowledge Required:

• ICD diagnostic codes for medical diagnoses, assignments, groupings, and treatments.

• Agency statutes, rules, policies, and procedures.

• Human anatomy and physiology.

• Coding theory and application to agency laws, rules, and policies.

• Business management and public/human relations.

• Federal and state laws (e.g., ORC), regulations, and accreditation standards (AAPC or AHIMA).

• Claims processing and data management.

• Healthcare delivery systems and health science administration.

• Health information systems and database management.

• Applied statistics.

• Process analysis and outcome analysis.

• Healthcare laws, regulations, and standards.

• ICD-9 and ICD-10 coding for medical diagnoses, assignments, and groupings.

Skills:

• Operating PC and peripheral equipment (e.g., modem, printer).

• Using Microsoft Office software (Windows, Excel, Word, Access, PowerPoint, Outlook).

• Using agency-specific software.

• Using office equipment (copiers, fax machines).

• Strong written and oral communication.

• Project management.

• Data collection, analysis, and presentation.

Ability to:

• Define problems, collect data, establish facts, and draw conclusions.

• Draft and edit administrative policies, procedures, and directives.

• Apply statistical analysis.

• Solve practical, everyday problems.

• Use proper research methods in gathering data.

• Gather, collate, and classify information about data, people, or things.

• Maintain accurate records and databases.

• Prepare concise and accurate reports.

• Establish rapport with internal and external customers.

• Prepare and deliver presentations to specialized and general audiences.

• Handle sensitive inquiries.

• Use and interpret ICD-9, ICD-10, CPT, and HCPCS medical coding publications.

Experience:

• 3–4 years of medical coding experience.

Education & Certifications:

• Education: RHIA or RHIT degree and/or CCS, CCS-P, or CPC.

• RHIT – Registered Health Information Technician

• RHIA – Registered Health Information Administrator

• CCS – Certified Coding Specialist

• CCS-P – Certified Coding Specialist – Physician-based

• CPC – Certified Professional Coder