Inpatient Lead Coder - Remote

Position Summary

Assigns appropriate codes to reflect all diagnoses and procedures extrapolated from physician and appropriate nursing documentation during a patient encounter according to the most current coding methodologies, including ICD-10-CM/PCS, resulting in appropriate reimbursement. Abstracts required data to input into the Medical Center's computerized database. Converts all patient visits and encounters into appropriate DRG (Diagnosis Related Group) assignments in order to correctly submit the optimal reimbursement for each patient encounter coded.

Responsibilities

• Assists IP Coding Manager with assignment of work to Coders, analysis of the daily unbilled report, and follow-up on unanswered physician queries and missing documentation.
• Aids PFS in researching unbilled accounts and updating incorrect discharge dispositions.
• Aids Coding Manager in orienting, training, and mentoring staff, providing ongoing education as needed.
• Aids IP Coding Manager as a resource and subject matter expert to outside departments.
• Aids IP Coding Manager in troubleshooting system issues with 3M encoder and EPIC.
• Aids IP Coding Manager with special projects as needed.
• Reviews patient medical records and abstracts medical data that identifies all diagnoses and procedures.
• Codes diagnoses, procedures, and appropriate modifiers from the medical record documentation using ICD-10-CM/PCS classification systems.
• Consults with the CDCI team to request appropriate physician or appropriate medical staff to clarify medical record information.
• Sets grouper codes to each record according to patient type and financial class.
• Enters coded/abstracted information in grouper, analyzes groupings, and assigns the appropriate grouper for appropriate and accurate reimbursement.
• Data enters abstracted information into the Medical Center's computerized database.
• Maintains coding accuracy rate of 95% or better.
• Maintains productivity standards set forth in Departmental Policies and procedures.
• Coordinates with HIM to track missing provider documentation so that all records can be coded and billed in a timely fashion.
• Maintains professional skills and knowledge of coding through attendance at in-service programs, conferences, workshops and other educational programs and review of current literature.
• Serves as resource for the Revenue Cycle Analysts in working claims in scrubber to clear for billing.
• Utilizes hospital’s behavioral standards as the basis for decision making and to facilitate the hospital’s goals and mission.
• Fulfills established Hospital infection control and safety procedures.
• Performs other duties as needed.

Requirements

• Education: Equivalent to an Associate's Degree in Health Information, Medical Records or similar program. An equivalent combination of education and experience, which provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements.
• Certifications/Licenses/Registrations: Requires inpatient CCS, RHIT or RHIA credentials from AHIMA. ACCS coding credential requires inpatient coding experience before taking exam. RHIT and RHIA must have associate’s and bachelor’s degree respectively before taking exam.
• Experience: Minimum of five years inpatient coding experience in a Level 1 Trauma, Teaching Facility.
• Knowledge and Skills: Work requires in-depth knowledge of medical terminology, ICD-10-CM/PCS and CPT-4 Coding conventions and knowledge of the various DRG systems (CMS DRGs, AP-DRG, and APR-DRGs). Strong knowledge of health records, computer systems, Microsoft applications, data integrity, and processing techniques required. Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines. Ability to work with accuracy and attention to detail. Ability to solve problems appropriately using job knowledge and current policies/procedures. Ability to work cooperatively with members of the healthcare delivery team and staff, ability to handle frequent interruptions and adapt to changes in workload and work schedule and to respond quickly to urgent requests. Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations. Solid (or could use excellent again) communication skills, both oral and written.

Compensation

$62,500.00- $91,000.00

Equal Opportunity Employer