Hospital Coding Specialist III

About the role

To ensure accurate and appropriate gathering of information into the coding classification systems to meet departmental, hospital and outside agency requirements. This includes ensuring appropriate reimbursement, compliance and charging with the various coding guidelines and regulatory agencies.

Responsibilities

• Responsible for obtaining accurate and complete documentation in the medical record for accurate coding/MS-DRG assignment, severity of illness and risk of mortality for each medical record.
• Responsible for the coding of the highly complex patient classes i.e. inpatient, interventional, etc.
• Codes inpatient and/or IRAD 90% of current FTE status.
• Reviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10-CM, ICD-10-PCS, CPT, or modifier codes for each diagnosis and procedure that is identified (inpatient and IRAD).
• Codes highly complex patient classes (inpatient and IRAD).
• Ensures appropriate MS-DRG assignment based on accurate ICD-10-CM and ICD-10-PCS coding assignment and medical record documentation.
• Assigns hospital codes to a variety of patient classes (i.e. I/P, IRAD, etc.).
• Affirms the accuracy, quality, and timely review of data needed to obtain a clean bill.
• Contacts physicians or any persons necessary to obtain information required for to accurately code assignments.
• Works and communicates with other offices in any manner necessary to facilitate the billing process.

Qualifications

• High School Diploma or Equivalent.
• Current HIM or Coding Certification through ONE of the following:
  • American Health Information Management Association (AHIMA)
  • American Academy of Professional Coders (AAPC)
• Three (3) years of hospital inpatient coding or interventional radiology (IRAD) hospital coding experience.

Preferred Qualifications

• Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program.

Core Duties and Responsibilities

• The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
• Codes inpatient and/or IRAD 90% of current FTE status.
• Reviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10-CM, ICD-10-PCS, CPT, or modifier codes for each diagnosis and procedure that is identified (inpatient and IRAD).
• Codes highly complex patient classes (inpatient and IRAD).
• Ensures appropriate MS-DRG assignment based on accurate ICD-10-CM and ICD-10-PCS coding assignment and medical record documentation.
• Assigns hospital codes to a variety of patient classes (i.e. I/P, IRAD, etc.).
• Affirms the accuracy, quality, and timely review of data needed to obtain a clean bill.
• Contacts physicians or any persons necessary to obtain information required for to accurately code assignments.
• Works and communicates with other offices in any manner necessary to facilitate the billing process.

Physical Requirements

• Must be able to sit for long periods of time.
• Must have visual and hearing acuity within the normal range.
• Must have manual dexterity needed to operate computer and office equipment.

Working Environment

• Standard office environment.
• Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material.
• May require travel.

Skills and Abilities

• Must be able to concentrate and maintain accuracy during constant interruptions.
• Must possess independent decision-making ability.
• Must possess the ability to prioritize job duties.
• Must be able to handle high stress situations.
• Must be able to adapt to changes in the workplace.
• Must be able to organize and complete assigned tasks.
• Must possess excellent written and verbal communication skills.
• Must possess the knowledge of anatomy, physiology and medical terminology.