Clinical Coder III

Coding

• Coding of complex inpatient records.
• Successful demonstration of proficiency and compliance with regulatory requirements.
• Identification of principal diagnosis and appropriate MS-DRG.
• Complete coding of the record including appropriate coding of secondary diagnoses and inpatient procedures using ICD-10-PCS.
• Ability to write compliant coding queries.

Qualifications

• Education/formal training/licensure/certification/experience: Degree in HIM. RHIA or RHIT preferred; CCS required.
• 4 years coding experience in hospital setting (at least 2 years inpatient).
• Experience in DRG validation or chart auditing preferred.
• Thorough understanding and experience in both ICD-10 and CPT 4 required.
• Minimum of 90% score on competency assessment.
• Must be consistently exceeding standards of Level II and/or score minimum of 90% on competency sampling.
• Knowledge of DNV, Joint Commission and other regulatory agency chart documentation requirements.
• Knowledgeable about prospective payments systems and coding guidelines.

Skills and Abilities

• Knowledgeable about DNV, Joint Commission and other regulatory agency chart documentation requirements.
• Ability to work independently and function as an integral team member within the department.
• Strong analytical skills, detail oriented, and able to make decisions independently with consideration of the potential impact to reimbursement as well as external audit.
• Able to work unsupervised and be self-motivated with a strong understanding of prospective payments systems and coding guidelines.
• Ability to perform work under pressure with ongoing deadlines and production/accuracy standards.
• Use of computerized encoder and computer experience in Windows environment.

Working Conditions

• Primary office setting, independent work environment.
• Minimal conversation in office to facilitate level of concentration required.

Physical Requirements

• Ability to tolerate long periods of sitting.
• Numerical perception/visual acuity.
• Excellent written and oral communication skills.
• Motor coordination for operating computer.