You are here

Home » State Human Resources » Compensation & job classes » Classified Job Listing » Specifications » State of Washington Class Specification

State of Washington Classified Job Specification

MEDICAL CODING SPECIALIST

<< Classified Job Listing

MEDICAL CODING SPECIALIST
183A
Category: Financial Services

Definition

Under general direction independently performs professional level work as an internal and external technical specialist for medical diagnostic coding, procedural coding and services performed by qualified healthcare providers.

Positions perform a variety of medical coding functions, such as: analyzing medical records to abstract information for appropriate medical diagnostic and services coding; assigns diagnoses and/or operative procedure codes; converts or corrects medical codes and services; reviews medical records for completeness and accuracy.

Typical Work

Reviews medical records to ensure accurate diagnostic codes and services to assist in recouping or adjusting health care payments and to follow federal mandates and compliance;

Researches medical or legal issues; monitors regulatory and policy requirements that affect ICD coding information;

Performs data entry and abstracts pertinent data from medical records to ensure data integrity and optimal reimbursement;

Performs comprehensive quality assurance or medical records reviews by abstracting medical record data; transfers data to between computer systems to identify trends and recommends corrections, procedural changes, and educational opportunities for internal staff and providers;

Trains external and/or internal health care providers and staff on medical diagnostic codes and services;

May lead or train staff performing same or similar duties within work unit or work group;

Performs other duties as required.

Knowledge and Abilities

Knowledge of: anatomy, physiology, medical terminology and medical coding guidelines, regulations and medical practice specialty.

Ability to: abstract information required to support accurate medical diagnostic coding; work effectively with program staff, medical providers, and other affected parties; communicate clearly and effectively both orally and in written form.

Legal Requirement(s)

There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.

Desirable Qualifications

Associate’s degree

AND

At least two years of experience in medical coding, medical billing, medical policy making or fee schedule creation with an emphasis on diagnosis coding.

AND

Current certification as a Certified Professional Coder with the American Association of Professional Coders (or equivalent) or ability to obtain certification within two years of hire.

Additional professionally related experience can be substituted year for year for the Associate’s degree.

Class Specification History

New class. Adopted June 13, 2019, effective July 1, 2019.

Took 0.811452 seconds ( total_time ) to process web service