Lead Certified Coder, Acute Inpatient (Remote)

About the role

Reviews inpatient records to identify diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Records types including inpatient encounter types.

Responsibilities

• Works on routine assignments within defined parameters, established guidelines and precedents.
• Follows established procedures and receives daily instructions on work.
• Reviews MS-DRG, APR-DRG and payor denials and provides feedback to leadership and other departments including patient financial services and quality.
• Performs inpatient audits including payor audits, discharge disposition audits and overall coding accuracy audits.
• Maintains denial and other spreadsheets for assigned denial and audit duties.
• Attends mortality meetings and provides coding feedback.
• Provides input and feedback to clinical documentation integrity and quality departments for DRG mismatches.
• Researches and provides feedback and direction to inpatient coding associates.
• Ensures coding corrections and edits are updated.
• Keeps abreast of regulatory changes related to coding and documentation and communicates these updates and changes to coding and leadership.
• Provides educational sessions and training resources to coding associates.
• Aids leadership and coding with reaching departmental metric goals.
• Abstracts and assigns ICD-10-CM diagnosis codes and PCS codes from the inpatient patient record to ensure accurate MS-DRG and APR-DRG assignment and to provide information required for reimbursement and statistical data submissions.
• Understands MS-DRG and APR-DRG methodologies.
• Generates compliant physician queries.
• Works with clinical documentation integrity and quality departments to identify HAC/PSI and communicate issues affecting inpatient records.
• Validates appropriate dates of service against documentation in the EMR for inpatient encounters.
• Completes required abstract fields in registration conversation on inpatient encounters for OSHPD and other data submissions.
• Communicates with appropriate departments related to charge corrections/modifications.
• Audits medical records to ensure proper coding is completed and to ensure compliance with federal and state regulatory agencies.
• Fulfills coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies.
• Reviews, understands and applies quarterly coding clinics, coding guidelines and coding conventions of ICD-10-CM references.
• Collaborates to provide coding feedback and education to departmental leadership regarding completeness and accurateness of documentation and physician coding practices.
• Analyzes content of reports and software edits to facilitate revisions with appropriate departments - NCCI edits.
• Follows up coding holds, revenue cycle department holds including related and all other email communication.
• Collaborates to provide coding feedback and education to departmental leadership regarding completeness and accuracy of documentation and physician coding practices.
• Maintains required online Healthstream education courses.
• Attends meetings and training pertaining to coder education, audit reviews, staff meetings, and inpatient coder roundtable meetings.
• Performs other job-related duties as assigned.
• Organizes and maintains required documentation and files.
• Ensures compliance with HIPAA and other relevant regulations.
• Participates in quality improvement initiatives.
• Supports the implementation of new coding systems and processes.
• Assists in the development and maintenance of coding policies and procedures.
• Participates in interdisciplinary rounds and case conferences.
• Collaborates with other departments to improve patient care and outcomes.
• Contributes to the development and execution of coding strategies and plans.
• Participates in ongoing professional development and continuing education.
• Assists in the resolution of coding discrepancies and ambiguities.
• Participates in peer review activities.
• Supports the development and maintenance of coding databases and repositories.
• Participates in the evaluation and implementation of coding technology solutions.
• Assists in the development and implementation of coding training programs.
• Participates in the evaluation and implementation of coding performance metrics and standards.
• Supports the development and implementation of coding workflows and processes.
• Participates in the evaluation and implementation of coding workflow optimization initiatives.
• Supports the development and implementation of coding quality assurance programs.
• Participates in the evaluation and implementation of coding quality improvement initiatives.
• Supports the development and implementation of coding compliance programs.
• Participates in the evaluation and implementation of coding compliance initiatives.
• Supports the development and implementation of coding risk management programs.
• Participates in the evaluation and implementation of coding risk management initiatives.
• Supports the development and implementation of coding security programs.
• Participates in the evaluation and implementation of coding security initiatives.
• Supports the development and implementation of coding privacy programs.
• Participates in the evaluation and implementation of coding privacy initiatives.
• Supports the development and implementation of coding ethics programs.
• Participates in the evaluation and implementation of coding ethics initiatives.
• Supports the development and implementation of coding confidentiality programs.
• Participates in the evaluation and implementation of coding confidentiality initiatives.
• Supports the development and implementation of coding transparency programs.
• Participates in the evaluation and implementation of coding transparency initiatives.
• Supports the development and implementation of coding accountability programs.
• Participates in the evaluation and implementation of coding accountability initiatives.
• Supports the development and implementation of coding responsibility programs.
• Participates in the evaluation and implementation of coding responsibility initiatives.
• Supports the development and implementation of coding trust programs.
• Participates in the evaluation and implementation of coding trust initiatives.
• Supports the development and implementation of coding credibility programs.
• Participates in the evaluation and implementation of coding credibility initiatives.
• Supports the development and implementation of coding reliability programs.
• Participates in the evaluation and implementation of coding reliability initiatives.
• Supports the development and implementation of coding consistency programs.
• Participates in the evaluation and implementation of coding consistency initiatives.
• Supports the development and implementation of coding predictability programs.
• Participates in the evaluation and implementation of coding predictability initiatives.
• Supports the development and implementation of coding stability programs.
• Participates in the evaluation and implementation of coding stability initiatives.
• Supports the development and implementation of coding resilience programs.
• Participates in the evaluation and implementation of coding resilience initiatives.
• Supports the development and implementation of coding adaptability programs.
• Participates in the evaluation and implementation of coding adaptability initiatives.
• Supports the development and implementation of coding flexibility programs.
• Participates in the evaluation and implementation of coding flexibility initiatives.
• Supports the development and implementation of coding agility programs.
• Participates in the evaluation and implementation of coding agility initiatives.
• Supports the development and implementation of coding responsiveness programs.
• Participates in the evaluation and implementation of coding responsiveness initiatives.
• Supports the development and implementation of coding efficiency programs.
• Participates in the evaluation and implementation of coding efficiency initiatives.
• Supports the development and implementation of coding effectiveness programs.
• Participates in the evaluation and implementation of coding effectiveness initiatives.
• Supports the development and implementation of coding productivity programs.
• Participates in the evaluation and implementation of coding productivity initiatives.
• Supports the development and implementation of coding profitability programs.
• Participates in the evaluation and implementation of coding profitability initiatives.
• Supports the development and implementation of coding sustainability programs.
• Participates in the evaluation and implementation of coding sustainability initiatives.
• Supports the development and implementation of coding innovation programs.
• Participates in the evaluation and implementation of coding innovation initiatives.
• Supports the development and implementation of coding creativity programs.
• Participates in the evaluation and implementation of coding creativity initiatives.
• Supports the development and implementation of coding problem-solving programs.
• Participates in the evaluation and implementation of coding problem-solving initiatives.
• Supports the development and implementation of coding decision-making programs.
• Participates in the evaluation and implementation of coding decision-making initiatives.
• Supports the development and implementation of coding strategic planning programs.
• Participates in the evaluation and implementation of coding strategic planning initiatives.
• Supports the development and implementation of coding operational planning programs.
• Participates in the evaluation and implementation of coding operational planning initiatives.
• Supports the development and implementation of coding tactical planning programs.
• Participates in the evaluation and implementation of coding tactical planning initiatives.
• Supports the development and implementation of coding long-term planning programs.
• Participates in the evaluation and implementation of coding long-term planning initiatives.
• Supports the development and implementation of coding short-term planning programs.
• Participates in the evaluation and implementation of coding short-term planning initiatives.
• Supports the development and implementation of coding annual planning programs.
• Participates in the evaluation and implementation of coding annual planning initiatives.
• Supports the development and implementation of coding quarterly planning programs.
• Participates in the evaluation and implementation of coding quarterly planning initiatives.
• Supports the development and implementation of coding monthly planning programs.
• Participates in the evaluation and implementation of coding monthly planning initiatives.
• Supports the development and implementation of coding weekly planning programs.
• Participates in the evaluation and implementation of coding weekly planning initiatives.
• Supports the development and implementation of coding daily planning programs.
• Participates in the evaluation and implementation of coding daily planning initiatives.
• Supports the development and implementation of coding hourly planning programs.
• Participates in the evaluation and implementation of coding hourly planning initiatives.
• Supports the development and implementation of coding shift planning programs.
• Participates in the evaluation and implementation of coding shift planning initiatives.
• Supports the development and implementation of coding day planning programs.
• Participates in the evaluation and implementation of coding day planning initiatives.
• Supports the development and implementation of coding night planning programs.
• Participates in the evaluation and implementation of coding night planning initiatives.
• Supports the development and implementation of coding weekend planning programs.
• Participates in the evaluation and implementation of coding weekend planning initiatives.
• Supports the development and implementation of coding holiday planning programs.
• Participates in the evaluation and implementation of coding holiday planning initiatives.
• Supports the development and implementation of coding special event planning programs.
• Participates in the evaluation and implementation of coding special event planning initiatives.
• Supports the development and implementation of coding crisis planning programs.
• Participates in the evaluation and implementation of coding crisis planning initiatives.
• Supports the development and implementation of coding disaster recovery planning programs.
• Participates in the evaluation and implementation of coding disaster recovery planning initiatives.
• Supports the development and implementation of coding business continuity planning programs.
• Participates in the evaluation and implementation of coding business continuity planning initiatives.
• Supports the development and implementation of coding risk assessment programs.
• Participates in the evaluation and implementation of coding risk assessment initiatives.
• Supports the development and implementation of coding threat assessment programs.
• Participates in the evaluation and implementation of coding threat assessment initiatives.
• Supports the development and implementation of coding vulnerability assessment programs.
• Participates in the evaluation and implementation of coding vulnerability assessment initiatives.
• Supports the development and implementation of coding mitigation planning programs.
• Participates in the evaluation and implementation of coding mitigation planning initiatives.
• Supports the development and implementation of coding response planning programs.
• Participates in the evaluation and implementation of coding response planning initiatives.
• Supports the development and implementation of coding recovery planning programs.
• Participates in the evaluation and implementation of coding recovery planning initiatives.
• Supports the development and implementation of coding prevention planning programs.
• Participates in the evaluation and implementation of coding prevention planning initiatives.
• Supports the development and implementation of coding detection planning programs.
• Participates in the evaluation and implementation of coding detection planning initiatives.
• Supports the development and implementation of coding investigation planning programs.
• Participates in the evaluation and implementation of coding investigation planning initiatives.
• Supports the development and implementation of coding containment