Coding Compliance Specialist (8a-5p) - Houston, TX

 
Position: Coding Compliance Specialist (8a-5p) - Houston, TX

Job ID: 142131

Location: US-TX-Houston

Department: REV CYCLE OPERATIONS & SUPPORT

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p

About Texas Children's Hospital

Texas Children’s Hospital Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.   Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital opening in 2017. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.   To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Summary:

 

We are searching for Coding Compliance Specialist- someone who works well in a fast-paced hospital setting. In this position you will interact with all revenue-generating departments in assigning revenue/CPT/HCPCS codes to the hospital chargemaster for the purpose of assuring compliance with government/non-government agencies and insurance companies. You will also be responsible for making recommendations regarding policies associated with job’s purpose and essential responsibilities.

 

Think you’ve got what it takes?

 



Responsibilities :

  • Assigns and maintains the appropriate place of service to the SIM form and in current EHR 
  • Assigns appropriate revenue codes in current EHR for all billable items 
  • Assigns appropriate SIM number to new items in the chargemaster 
  • Reconciles entry to ensure accuracy each time changes, additions, or deletions are made in current HER 
  • Reconciliation of changes involves using export files from the test EHR environments and comparing them through each environment to ensure entries are reflective of changes to the charge master 
  • Reviews potential billing and collection needs with departments. 
  • Reviews services with departments to ensure revenue/CPT/HCPCS codes correspond with services to be rendered. 
  • Investigates new services and/or significant changes to existing services to determine billing validity and mechanism 
  • Coordinates and maintains all necessary information needed for chargemaster review consultants or other personnel 
  • Participates in the on-site review of Hospital’s chargemaster to verify presented recommendations. Documents identified problems/issues during review and resolves issues at the direction of the Manager based on the final report 
  • Updates SIMs once recommendations for changes are researched and approved 
  • Reviews and interprets information related to the regulatory healthcare environment by monitoring appropriate federal, state, and healthcare industry websites, publications, and journals. 
  • Review and correct charge/coding related edits or collaborate with responsible departments in order to correct the edits. 


Qualifications:

  • High school diploma or GED 
  • One of the following: 
  • Certified Professional Coder (CPC) issued by the America Association of Professional Coders 
  • Certified Coding Specialist (CCS) issued by the American Health Information Management Association 
  • Registered Health Information Administrator (RHIA) issued by the American Health Information Management Association (AHIMA) 
  • Registered Health Information Technician (RHIT) issued by the American Health Information Management Association (AHIMA) 
  • Three (3) years of experience as a Coder

 

 



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