icims
Clinical Documentation Coding Specialist II
University of Utah
Remote, USA
Full-time
Mid · 3+ years experience
Remote
Discovered Today
Epic3M 360 Encompass R2Microsoft Office
Free
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Epic3M 360 Encompass R2Microsoft Office
Key Skills for This Role
Epic3M 360 Encompass R2Microsoft Office
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Essential Functions
Performs thorough review of medical record for identification of relevant clinical diagnoses and procedures performed.
Assigns appropriate ICD-CM principal diagnosis code.
Assigns appropriate ICD-CM secondary diagnosis codes.
Assigns appropriate ICD-10 PCS code(s).
Sequences principal and secondary diagnoses codes and primary procedure code for accurate MS-DRG and APR-DRG assignment.
Assigns Present on Admission (POA) indicator for each diagnosis code.
Abstracts required data elements, including but not limited to: Admit Type, Admit Source / Point of Origin, and Discharge Disposition.
Expands understanding / identification of opportunities where additional provider documentation is required to thoroughly and accurately assign ICD-10 code.
Understands and adheres to compliant provider query practices and procedures.
Understands and adheres to Health Information Coding policies and Official Coding Guidelines, as published by CMS and Cooperating Parties.
Knowledge / Skills / Abilities
- Proficient knowledge of medical terminology, anatomy & physiology and pathophysiology.
- Knowledge of basic coding conventions & use of coding nomenclature.
- Developing knowledge of health care quality related initiatives.
- Demonstration of acceptable progression through service lines of increasing complexity.
- Achieve and sustain acceptable productivity rate as defined by Coding Leadership.
- Ability to effectively communicate with clinical staff and other hospital department personnel.
- Knowledge of healthcare IT systems, preferably Epic and 3M 360 Encompass R2.
- Knowledge of Microsoft Office.
- Team player, ability to collaborate with colleagues and leadership.
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