Company : Highmark Health Job Description : JOB SUMMARY This job assigns codes (ICD-9, 10, CPT and HCPCS) which most accurately describe diagnosis, procedures and therapies according to established guidelines.
The incumbent assigns and sequences ICD-9 CM/CPT/HCPCS and ICD-10 codes to diagnoses and procedure for the documented information.
ESSENTIAL RESPONSIBILITIES Compile, abstract and maintain patient medical records to document condition and treatment.
Actively code diagnoses (ICD-9) based on medical record documentation.
Review records for completeness, accuracy and compliance with regulations.
Protect the security of medical records to ensure that confidentiality is maintained.
Participate in inter-rater reliability testing/peer review exercises, as requested.
Other duties as assigned or requested.
EDUCATION Required Associate’s Degree Substitutions 3 years of related and progressive experience in lieu of Associate’s degree Preferred None EXPERIENCE Required 1 years of Coding Experience with commercial claims and/or medical/surgical products or Medicare advantage or Medicare fee for service program coverage Experience with the Common Procedure Coding System (HCPCS) Experience with International Classification of Diseases (ICD-9, ICD-10) information Preferred None LICENSES AND CERTIFICATIONS Required (one of the following) Registered Health Information Administrator (RHIA) Registered Health Information Technician (RHIT) Certified Coding Specialist (CCS) Certified Professional Coder (CPC) Preferred None SKILLS Knowledge of coding International Classification of Diseases, 9th Revision (ICD-9) codes Understands and applies appropriate Centers for Medicare & Medicaid Services (CMS) guidelines to coding Knowledge of anatomy, physiology and medical terminology Coding software familiarity Excellent verbal, math and written communication skills Data entry Language (Other than English): None Travel Requirement: 0%
– 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title.
It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.
In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct.
This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law.
Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law.
Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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