As part of our continued commitment to providing a safe and healthy workplace, Phoenix Children’s is officially a mandatory COVID-19 vaccination organization, effective October 1, 2021. All new employees must be fully vaccinated prior to starting employment at Phoenix Children’s. Having a vaccinated workforce is an important step in supporting our mission to provide hope, healing and the best healthcare for the children in our community.

Position Details

Department: CORP | Professional Svcs Coding
Category: Hlth Info Mgmt/Med Records
Location: Telecommuting
Posting #: 725553
Date Posted: 1/30/2023
Employee Type: Regular

Position Summary

Under direct supervision of the Manager of Professional Services, performs functions as both coding auditor and educator and is responsible for providing oversight on education and audits of medical records for compliance with federal coding regulation and guidelines. This position is responsible for the coordination of auditing and education in support of achieving organizational strategic initiatives. The position has a shared responsibility to assist in achieving teams goals. Uses knowledge of PCH policies and procedures to provide a second level review of all Codes (CPT, EM, ICD-10 etc.) to achieve and maintain compatibility with Government and PCH billing requirements and compliance standards. This position also assists with coding production as needed; reviews and resolves coding issues related to billing, researches complex coding issues, and participates in process improvements related to coding and EM management.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. Ensures compliance with Federal Coding Documentation Guidelines and PCH/PCMG official coding policies.
    • Ensures compliance with Federal Coding Documentation Guidelines and PCH/PCMG official coding policies.
    • Audits medical record documentation of Ambulatory services to verify the accuracy and specificity of all assigned codes, modifiers, POS, units, etc.
    • Provides documentation/coding education to coders and providers to maximize accuracy, completeness and compliance with accepted standard of practice and current coding guidelines.
    • Maintains current department policies related to coding and documentation requirements.
    • Collaborates with other disciplines and departments as a change agent and participated in the evaluation of outcomes.
    • Researches and resolves complex coding/documentation issues.
  2. Performs internal coding and documentation quality reviews of coded Ambulatory services and professional fee assignment of medical records to verify the accuracy and specificity of assigned codes in accordance with documentation guidelines.
  3. Educates Communicates with providers and coders regarding medical record documentation in order to maximize accuracy, completeness, and compliance with accepted standards of practice and current coding guidelines.
  4. Reviews accounts, when requested by the Physician Billing and Revenue Cycle Department and other clinical departments to research and resolve coding issues related to billing.
  5. Participates in continuing education activities to maintain current credentials, as well as to enhance knowledge and skills.
  6. Reviews Medical records for appropriate Diagnosis/EM/CPT/HCPCS codes and modifiers in compliance with Official Documentation Guidelines for Coding and Reporting as well as PCMG coding policies.
  7. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
1. High School Diploma or equivalent. Required
2. Associates/Bachelor degree in Health care related field Preferred
Do you meet this requirement?
1. Three or more years of experience in a hospital or professional entity Required
2. One year of Physician E/M Auditing experience. Required
3. Comprehensive knowledge of ICD-10-CM Official Guidelines for Coding Reporting, ICD and CPT/HCPCS coding classification systems, including facility and physician E/M, and hospital coding and reimbursement software. Required
4. Experience in developing training documentation and delivering training to individuals and groups. Required
5. Previous experience interacting with external/internal coding staff, auditors and leadership. Preferred
Do you meet this requirement?
1. CPC, CCS-P, CCS or RHIT or other accredited Coding credentials through AAPC or AHIMA Required
2. CPMA or other accredited Auditing certification through and accredited source such as the AAPC or AHIMIA Preferred
Do you meet this requirement?
Special Skills
1. Medical Terminology and an understanding for the laws and regulations associated with medical records functions Required
2. Previous work with Auditing software Preferred
3. Versed in regulatory requirements for medical record documentation, as well as Medical staff Rules and Regulations where applicable Preferred
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Climbing Occasionally
2. Physical Requirement - Feeling (sensing textures and temperatures) Frequently
3. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Constantly
4. Physical Requirement - Hearing Constantly
5. Physical Requirement - Pushing/pulling Occasionally
6. Physical Requirement - Reaching Occasionally
7. Physical Requirement - Sitting Constantly
8. Physical Requirement - Standing Occasionally
9. Physical Requirement - Stooping/crouching/kneeling/crawling Occasionally
10. Physical Requirement - Talking Frequently
11. Physical Requirement - Walking Frequently
12. Physical Requirement - Near Vision Constantly
13. Physical Requirement - Far Vision Constantly
14. Physical Requirement - Color Discrimination Occasionally
15. Physical Requirement - Use of keyboard, mouse and/or computer equipment Occasionally
16. Physical Requirement - Lift up to 35 pounds without assistance Occasionally
17. Occupational Exposure/Risk Potential - Inside office environment Applicable
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply