HIM Inpatient Coding Specialist III

Responsibilities

• Examines the complete medical record to accurately determine the principal & secondary diagnoses, procedures, comorbidities and complications demonstrating 96% accuracy as determined by audits.
• Sequence the diagnoses & procedures to obtain the optimal DRG or APR-DRG assignment and demonstrates 96% accuracy as determined by audits.
• Simultaneously abstracts and enters all coded information into the HDM/ClinTrac system for timely billing.
• Refers charts that require clarification of vague or unclear documentation for accurate coding and DRG assignment to a Coding Quality Specialist to query the physician for the needed documentation.
• Promptly and accurately assigns Coding Hold reasons to all records that cannot be completed immediately due to: Missing Operative Notes, Missing Pathology Report, Physician Query Needed, Death Review, Discharge Disposition, Missing Other Reports (Card Cath, EPS, etc).
• Willing to adjust schedule to complete workload and meet pivotal revenue cycle deadlines when requested by management.
• Cooperates with departmental work volumes by adjusting work schedule.
• Correctly identifies and applies Present on Admission indicators to all applicable diagnoses according to designated guidelines.
• Accuracy is important due to the far reaching impact on reimbursement and quality metrics.
• Consistently codes the oldest cases first and prioritizes high dollar cases over 4 days old first.
• Strives to become fluent in the inpatient coding at all of the UPHS facilities.
• Performs revenue cycle/DNFB activities as needed.
• Reviews and processes provider queries.
• Sets priorities for high dollar and death charts to the coding staff.
• Performs SMART reviews.
• Affords assistance to the Coding Manager with other duties as assigned.

Qualifications

• HS Diploma/GED.
• 2 + years of previous work experience coding at an inpatient academic medical center.
• Certified Coding Specialist AHIMA.
• Bachelor's degree (Preferred).