The Sr. Content Specialist is responsible for creating, maintaining and testing the clinical and coding content within TruBridge Encoder. This includes proactive research of changes to coding standards include ICD10, HCPCS and CPT coding systems. Responsibilities including the monitoring of websites and source information for changes to coding and clinical rules, regulations and guidelines including CCI, MUE, Medical Necessity and Physician Fee Schedule content for professional and facility coding. Interact and coordinate with business partners who provide source content to the product. Work collaboratively with the product owner on new features that are required to ensure adherence to the guidelines and coding standards. Participate in the QA process to test clinical functionality as needed.
These Goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job related duties as required. Goals and objectives are subject to change.
All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate.
Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:
Minimum Requirements:
- Researching and creating content for the following TruBridge Encoder Product Features
- Coding Advice – create textual recommendations on coding particular diagnoses and procedures, based on official sources
- Coding Clinic – review articles, and assign appropriate indexing terms and codes
- CPT and ICD code mapping – create map of new codes to clinically equivalent codes in previous versions of the classifications
- CPT Assistant – review articles, and assign appropriate indexing terms and codes
- CPT Advanced Knowledgebase
- Code Descriptions – create medium descriptions for ICD and HCPCS codes
- Code and Modifier Edits - Relational edits based upon coding guidelines
- CPT Books - QA, update with code symbols, add brackets around exclusionary terms.
- HCPCS Tabular - QA, update with code symbols, add brackets around exclusionary terms.
- Custom Index lines - Create additional index terms to be incorporated into the Code Books
- Synonyms - Create acronyms, abbreviations and alternative wording to be used in the Index search.
- ICD-10-CM / PCS Guidelines – review and assign appropriate indexing terms and codes
- Code Sets - create commonly used groups of codes
- Edits – Create code edits as related to official coding guideline found in the approved sources
- Creating test cases for assigned areas
- Performing testing (QA) of the application, services, and TruCode Encoder Essentials as necessary
- Providing back up product support as scheduled
- Providing front line telephone product support to customers application as necessary
- Performing other related activities, as requested by the Product Owner
Required Education and Experience:
- Bachelor’s degree (or equivalent experience)
- Health Information Professional in Professional Coding, minimum of 5 years experience
- User of Professional and Facility Encoding solutions and TruBridge Encoder
- Minimum RHIT / CCS
- Experience with HIM software - encoder, abstractor
- Extensive background (5 years minimum) professional coding, classification systems, reimbursement methodologies
- Knowledge-base of HIM resources and reference tools (i.e. regulatory changes)
- Experience with MS Office software - Excel, Word, etc
- Excellent communication (written and oral) and interpersonal skills.
- Strong organizational, multi-tasking, and time-management skills.
- Must be detail oriented and able to follow through on issues to resolution.
- Must be able to act both independently and as a team member.
Professional