| Description
   
  The Coding Analyst reports to the Manager of Coding and will demonstrate expertise in the coding and analysis of pediatric medical records. The Coding Analyst is responsible to review, analyze, and code diagnostic and procedural information for technical or professional services that determine the care and treatment provided to the patient. The primary function of this position is to perform ICD-10-CM, CPT, ICD-10-PCS (IP tech/DRG) and HCPCS coding for Medicare, Medicaid and private insurance payments. The coding function will ensure compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. Qualifications
   
  Minimum EducationHigh School Diploma or GED (Required) And
 Associate's Degree (Preferred)
 
 Minimum Work Experience
 1 year Hospital-based coding experience required; pediatric experience preferred. (Required)
 
 Functional Accountabilities
 Productivity and Accuracy
 
 
    Assign and sequence ICD-10-CM/CPT/HCPCS/ICD-10-PCS (IP tech/DRG) codes to diagnosis and operative procedures for documented information; assure the final diagnosis and operative procedures as stated by the physician are valid and complete; abstract all necessary information from health records to identify secondary complications and co-morbid conditions.  
    Meet department accuracy and productivity standards for coding, abstracting, and record reconciliation activities.  
    Billing DocumentationAbstract all necessary information and assign codes ICD-10-CM/CPT/HCPCS/ICD-10-PCS (IP tech/DRG) , which most accurately describe each documented diagnosis, surgical procedure and special therapy or procedure according to established guidelines  
 
    Identify services needing to be abstracted/coded by following prescribed procedures for the capture of inpatient and outpatient services; this may involve the use of admissions, transfer and discharge reports, appointment schedules, and/or surgical schedules.  
    Abstract applicable clinical documentation (e.g. admit report, consultation report, progress note, surgical report, etc...) for purpose of determining the appropriate billing information (e.g. provider name, date of service, CPT code, ICD-10 code, modifier(s), etc...).  
    VerificationEnsure that all documented services are captured and coded and that all coding work is performed in a manner consistent with applicable coding rules and conventions.  
 
    Perform a comprehensive review of the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered. 
    Analyze provider documentation to assure the appropriate Evaluation & Management (E & M) levels are assigned using the correct CPT code. 
    Evaluate the record for documentation consistency and adequacy; ensure the final diagnosis accurately reflect the care and treatment rendered; review the records for compliance with established third party reimbursement agencies and special screening criteria. 
    Determine the final diagnosis and procedures stated by the physician or other health care providers are valid and complete. Organizational Accountabilities
 Organizational Accountabilities (Staff)
 Organizational Commitment/Identification
 
    Anticipate and responds to customer needs; follows up until needs are met Teamwork/Communication
 
    Demonstrate collaborative and respectful behavior 
    Partner with all team members to achieve goals 
    Receptive to others' ideas and opinions Performance Improvement/Problem-solving
 
    Contribute to a positive work environment 
    Demonstrate flexibility and willingness to change 
    Identify opportunities to improve clinical and administrative processes 
    Make appropriate decisions, using sound judgment Cost Management/Financial Responsibility
 
    Use resources efficiently 
    Search for less costly ways of doing things Safety
 
    Speak up when team members appear to exhibit unsafe behavior or performance 
    Continuously validate and verify information needed for decision making or documentation 
    Stop in the face of uncertainty and takes time to resolve the situation 
    Demonstrate accurate, clear and timely verbal and written communication 
    Actively promote safety for patients, families, visitors and co-workers 
    Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance Primary Location
  :
   
  District of Columbia-Washington Work Locations
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  Remote Work Location 111 Michigan Avenue NW
   Washington
    
   20010 Job
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  Health Information Management and Coding Organization
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  Finance Position Status
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  R (Regular)
   
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  FT - Full-Time Shift
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  Day Work Schedule
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  8-5pm Job Posting
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  May 13, 2025, 5:58:11 PM Full-Time Salary Range
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  59155.2
   
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  98571.2 |