Medical Coder I - Hosp IP

Responsibilities

• Assigns International Classification of Diseases 10-CM diagnostic and ICD-10-PCS procedural codes accurately and productively.
• Groups codes and completes product into payment groups.
• Assigns codes that affect Severity of Illness and Risk of Mortality and Hierarchal Condition Categories (HCCs).
• Participates in DRG Reconciliation with CDS.
• Queries providers when documentation is conflicting, needs clarification, and specificity.
• Analyzes information for optimal and proper reimbursement.
• Ensures compliance with all appropriate coding, billing, and data collection regulations and procedures.
• Provides information to physicians and other healthcare staff regarding current coding practices and changes in third-party, state, and federal regulations and guidelines.
• Reviews, analyzes, and abstracts physician/other documentation for diagnoses, procedures, and other services provided.
• Obtains missing information and clarifies existing information.
• Accepts feedback from Auditor and evaluates results from audited records as needed for educational purposes to avoid future errors.
• Researches appropriate databases for validation of information.
• Utilizes a variety of software (e.g. Epic, Optum CAC, MS Office, etc.) to compile and validate medical information.

Requirements

• High School diploma or GED.
• Successful completion of the UNC HCS IP Coder Proficiency Test (non AMC).
• One of the following certifications: AHIMA (American Health Information Management Association) certification and credential, AAPC (American Academy of Professional Coders) certification and credential.
• Two (2) years of experience in hospital coding.

Knowledge/Skills/Abilities

• Strong knowledge of ICD-10 coding with excellent analytical and data mining skills.
• Effective management of projects, planning, and implementing programs, and evaluating outcomes.
• Effective working with various levels of staff (including on-site and remote).
• Excellent communication skills, both written and verbal.
• Extensive attention to detail.
• Effective organizational skills, time management, and management of multiple priorities.
• Knowledge of Medical Terminology and Anatomy and Physiology.
• Able to interpret federal and state regulations as they relate to coding and compliance.