University of Washington Human Resources

UW CODE AND REPRESENTATIVE GROUP

18212 Coding Specialist 2 (NE S SEIU 925 Non Supv)
21212 Coding Specialist 2 (NE H SEIU 925 Non Supv)

BASIC FUNCTION

Review clinical documentation and assign codes supported by patient health records; perform facility or professional fee charge entry and/or abstract pertinent data from medical records to ensure data integrity and optimal reimbursement.

DISTINGUISHING CHARACTERISTICS

Under general direction, perform coding and/or charge submission of abstract Current Procedural Terminology (CPT) and/or Current Dental Terminology (CDT) facility or professional fee coding and billing. Analyze the medical record to assign International Classification of Diseases (ICD), CPT and/or Healthcare Common Procedure Coding System (HCPCS) codes and/or modifiers to ensure correct code assignment and optimal reimbursement in compliance with state and federal guidelines.

TYPICAL WORK

Review available electronic and other appropriate documentation to identify all billable procedures and services requiring facility and/or professional fee coding, ensuring all necessary codes use the appropriate ICD, CPT and/or HCPCS code. Ensure coded services, charges and clinical documentation meet appropriate guidelines or standards;

Review and resolve coding edits, claim edits and denials in Epic;

Consult with physicians and/or clinical department representatives, as appropriate, to verify services rendered and documented. Provide feedback to assist in the understanding of coding and documentation issues and opportunities;

Maintain turnaround times for coding and understand charge lag impact for facility and professional fee services;

Identify potentially avoidable delays for reimbursement and help identify systemic issues that contribute to delays in service or inefficient uses of resources to address root cause and prevent ongoing errors;

Serve as a resource for current coding, billing and regulatory guidelines;

May assist in the development and maintenance of the coding manual, standards, and policies and procedures for coding;

May assist in the investigation and research of billing and coding issues as related to inquiries, complaints or audit results, as requested;

May assist with training of new staff;

May perform special projects;

Perform related duties, as required;

May perform the work of lower level classifications of the Coding Specialist series.

MINIMUM QUALIFICATIONS

High school diploma or equivalent

AND

Certified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC).

AND

Two years coding experience coding or equivalent education/experience.

CLASS SPECIFICATION HISTORY

New Classification: Coding Specialist series effective 09-01-2017 as agreed to with SEIU 925. New series incorporates the work previously performed in the Clinical Data Specialist series.

Revised basic functions and distinguishing characteristics: 05-01-2023