Coder III - Hospital Coding

About the role

PeaceHealth is seeking a Coder III – Hospital Coding for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $34.74 – $52.12. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Job Summary

Supports the HIM Coding team by providing the highest level of coding expertise, internal review support and resolution of problematic coding. Regularly assists in the mentoring and training of coding caregivers and acts as a role model for team members by assisting Coding Leadership in testing and updating coding software, providing support for major implementations and representing the HIM team on critical projects, processes, and initiatives. Utilizes knowledge of medical terminology, anatomy, physiology, 3M encoding software, coding conventions, and local medical review policy to provide coding for inpatient and/or outpatient medical records to ensure accurate, complete and consistent coding for quality data.

Responsibilities

• Reviews medical record documentation and code the diagnoses and procedures using ICD-10-CM and CPT-4 coding conventions for the purpose of reimbursement, research, and compliance with federal regulations.
• Reviews the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital charges.
• Abstract information from medical records following established methods and procedures.
• Identify problem documents and work with submitting departments to correct errors.
• Responsible for handling more complex coding specialties, researches issues and resolves problem cases.
• Troubleshoots and identifies questionable patterns in hospital coding and recognize regulatory concerns that may impact PH facilities and/or specialized areas of care such as CAH, Psych, LTC, etc.
• May assist in various types of internal coding reviews and the mentoring and training of coding caregivers.
• May assist with internal coding reviews, expanded coordination of efforts with CDI nurses, and claim edit correction.
• Participate and support testing and implementation of software and EMR, including updates, and functions as a super user/subject matter expert.
• Assists in providing corrections for external reporting to state departments of health or other regulatory bodies as requested.
• Proficient/able to code across multiple patient types.
• Performs other duties as assigned.

Qualifications

Education

• Completion of a college based or AAPC/AHIMA approved coding education program

Experience

• Minimum of 5 years directly related work experience in inpatient acute care, hospital-based coding and abstracting for IPPS reimbursement or ambulatory surgery coding.
• Formal training or college coursework from an accredited school, in lieu of experience may be considered
• The use of ICD-10-CM and CPT-4 coding systems
• Knowledge of acute care and critical access reimbursement requirements

Credentials

• Registered Health Information Administrator
• or Registered Health Information Technician
• or Certified Coding Specialist
• or Certified Professional Coder
• or Certified Professional Coder – Hospital
• or Certified Outpatient Coder
• or Certified Inpatient Coder

Skills

• Ability to maneuver through multiple computer applications including encoders, abstracting, groupers, EMR and MS Office applications including Excel and Word required
• Proficient in spreadsheets and databases
• Effective written and verbal communication skills
• Ability to understand and carry out instructions furnished in written, verbal or diagram form
• Demonstrated good judgment and decision-making skills
• Good organizational skills and attention to detail
• Excellent critical thinking and problem-solving skills
• Able to work in an independent and/or remote environment
• 3M computer assisted coding experience (Preferred)
• Epic EMR experience (Preferred)

Working Conditions

• Consistently operates computer and other office equipment.
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
• Sedentary work.

Environmental Conditions

• Predominantly operates in an office environment.
• Ability to communicate and exchange accurate information.
• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.