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Senior Coding Specialist

Job Details

Job Type

Full-time, Part-time

Annapolis Junction, MD, MD

Medical Professionals

Description

SENIOR CODING SPECIALIST

AND

SENIOR CODING SPECIALIST (PART-TIME)

(MEDICAL RECORD TECHNICIAN)

Summary/Objective:

The Senior Coding Specialist independently reviews, accurately assigns, and abstracts diagnostic and procedural codes to encounters using designated coding classifications.

Primary Duties:

• Performs validation of Medicare Severity Diagnosis Related Groups (MS-DRG) reviews.
• Adheres to and maintains required performance levels in both coding accuracy and productivity.
• Reviews electronic and scanned medical records and compares codes submitted by hospitals to documentation.
• Maintains concurrent entry in the case review information system for all cases selected for review.
• Records clear and concise rationales for review decisions citing appropriate references as applicable.
• Demonstrates clear written and oral communication skills utilizing proper grammar, punctuation, spelling, and syntax.
• Interacts with physicians to obtain pertinent medical input that might impact coding decisions.
• Ensures both coder and physician rationales are precise and complete.
• Interacts with educators regarding potential hospital coding patterns.
• Composes letters to providers explaining review details and recommends changes to the codes and MS-DRGs submitted.
• Protects the confidentiality of patient information through compliance with the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH).
• Attends annual security awareness, rules of conduct, and conflict of interest training.
• Performs other duties as assigned.

Requirements

Essential Knowledge:

Advanced knowledge of International Classification of Diseases (ICD)-10 codes and Diagnosis Related Group (DRG) classification system. Experience using industry tools, such as Encoder, Grouper, and American Hospital Association (AHA) Coding Clinic.

Essential Education:

Preference for personnel with current unrestricted credentials of Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS). License must be recognized in the jurisdiction(s) relevant to the work assigned. For example, for a federal contract the license must be issued by a body within the United States.

Registered Nurses (RNs) and other personnel with medical degrees will be considered if they have a proven track record of auditing clinical coding and supporting clinical documentation. Must be able to apply all relevant ICD-10 diagnosis and procedure coding guidelines for appropriate MS-DRG assignment.

This position requires notifying a Livanta HR Manager in writing within five calendar days if there is any status change or disciplinary proceeding relating to any of Employees licenses or certifications, including, but not limited to, (1) restrictions on an employees license or certification, (2) changes to the states in which Employee can practice (3) revocation or expiration of any license or certification, and (4) any potential or actual disciplinary action against Employee by a certifying or licensing body.

Essential Skills:

Must have senior-level inpatient hospital coding experience. Must write in plain language, summarizing medical facts and coding principles that support coding decisions, including appropriate references from authoritative sources. Must be able to coordinate work and communicate efficiently with physician reviewers responsible for making clinical decisions.

Organizational "Fit" Considerations:

This position may require extended work hours during the week, weekends, holidays, and on-demand.

SENIOR CODING SPECIALIST PART-TIME)

Additional Considerations

SCA Coverage:

Company is a federal contractor under the McNamara-O'Hara Service Contract Act (SCA).

The McNamara-O'Hara Service Contract Act (SCA) covers prime contracts of over $2,500 entered into by the federal government and the District of Columbia. The principal purpose of the contract is to furnish services in the U.S. through the use of service employees. The definition of "service employee" includes any employee engaged in performing services on a covered contract other than a bona fide executive, administrative, or professional employee who meets the exemption criteria outlined in 29 Code of Federal Regulations (CFR) 541. Under the SCA, covered employers must pay the prevailing wages and benefits in the localityas determined by the U.S. Department of Labor (DOL) in a wage determination.

The position of Senior Coding Specialist (Part-Time) is considered a "service position" and is mapped to the Occupation Code and Title 12190 - Medical Record Technician of the current Wage Determination. For more information on this Occupation Code, please refer to the SCA Directory of Occupations at https://www.dol.gov/whd/regs/compliance/wage/SCADirV5/SCADirectVers5.pdf.

Wage Determinations and Employee Rights on Government Contracts are posted in break rooms (or an alternative location where labor law posters are displayed) for employees to review.

Livanta LLC is an equal employment opportunity / affirmative action employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All personnel processes are merit-based and applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military and veteran status or any other characteristic protected by applicable law. Livanta believes that diversity and inclusion among our teammates is critical to our success and we seek to recruit, develop and retain the most talented people from a diverse candidate pool.

If you need assistance or an accommodation due to a disability, you may contact us at 757-306-4920 or hr@livanta.com.

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