Inpatient Hospital Coder

Performs detailed work involved in the analysis and coding of health information for hospital facility services.

SCHEDULE: Monday-Friday. Flexible 8-hour shift between the hours of 6a-6p.

MAJOR RESPONSIBILITIES & DUTIES:

Responsible for thorough and accurate coding of diseases and procedures of each inpatient/hospital record through the use of ICD-10-CM and ICD-10-PCS coding manual and 3M encoder to ensure correct assignment of the Medicare Severity-Diagnosis Related Group, (MS-DRG) or All Patient Refined Diagnosis Related Group, (APR-DRG.)

Responsible for verification of the patient's discharge disposition and to ensure the appropriate present on admission, (POA) indicators are assigned to each code. The assigned codes must support the reason for the visit that is documented by the provider in order to support the care provided.

Responsible to assist with writing appeals or resolving coding & reimbursement issues with Pt Financial Services staff and third-party payers for Diagnosis Related Group (DRG) issues and denials in order to support the assigned Diagnosis Related Group, (DRG) and to address the clinical documentation utilized in the decision-making process to support the validity of the assigned codes and assists in implementing solutions to reduce back-end billing errors.

Collaborates with the CDI team and members of the medical staff to ensure completeness of documentation in the charts so that appropriate codes, and ultimately the correct Diagnosis Related Group (DRG,) may be assigned, while focusing on maximizing revenue and reimbursement opportunities.

Remain abreast of current Centers for Medicare and Medicaid Services, (CMS) requirements as well as Correct Coding Initiative, (CCI) edits, Hospital Acquired Conditions, (HAC's) and when applicable, National Coverage Determinations, (NCDs) and Local Coverage Determinations, (LCDs,) including the addition of appropriate modifiers to ensure a clean claim the first time through.

Conduct focused coding/encounter audits across multi-specialty practices to include providing brief yet detailed accounts of findings as well as suggested action plans for corrected claims and provider/staff education to the Hospital Coding Supervisor.

Provides back-up to the Professional Coding team as needed to meet all coding group KPI’s and metrics.

Abides by the Standards of Ethical Coding as set forth by the American Information Management Association (AHIMA) and adheres to official coding guidelines and organizational compliance.

KNOWLEDGE, SKILLS, AND ABILITIES:

Ability to apply thorough knowledge of ICD-10-CM and ICD-10-PCS coding theory with sustained accuracy of 95% or greater, while consistently maintaining acceptable productivity metrics set for the Hospital Coding team.

Ability to apply a thorough knowledge of medical terminology, disease process, and anatomy and physiology to hospital coding practices.

Working knowledge of coding classification systems to include Diagnosis Related Groups, (DRGs) and All Patient Refined - Diagnosis Related Groups, (APR-DRGs.)

Ability to function independently, with minimal supervision, as well as part of a team

Ability to communicate clearly and concisely both orally and in writing with all staff, physicians, and patients in all aspects of the job to allow efficiency and promptness for patient care.

Thorough knowledge of medical record content to include electronic medical records, (EMRs.)

Ability to type 30 wpm with at least 90% accuracy.

Ability to make rapid and accurate arithmetic calculations

Ability to maintain current and accurate records.

Ability to treat information in patient records with strict confidentiality.

Good verbal and written communication skills.

Strong attention to detail and critical thinking skills. 

REQUIRED QUALIFICATIONS:

High school diploma or equivalent required.

A current Inpatient Coding Certification (CCS or CIC) required.

Minimum of one year of recent facility coding experience required. 

PREFERRED QUALIFICATIONS:

Extensive knowledge of medical terminology, disease process and anatomy and physiology preferred.

Experience working in Electronic Medical Record (EMR) preferred.

Working knowledge of UB04 billing preferred.

Other Duties: This job description incorporates the essential functions and duties required for this position. However, other duties may be required and assigned at times and as determined by a supervisor in order to meet the needs of the organization.

Serves as a role model in carrying out activities and behaviors that reflect the values and principles of the Boys Town mission.

PHYSICAL REQUIREMENTS, EQUIPMENT USAGE, WORK ENVIRONMENT:

Position is relatively sedentary in a normal office administrative environment involving minimum exposure to physical risks.  Will use office equipment such as a computer/laptop, monitor, keyboard, and a general workstation set-up.

Care and respect for others is more than a commitment at Boys Town – it is the foundation of who we are and what we do.

At Boys Town, we cultivate a culture of belonging for all employees that respects their individual strengths, views, and experiences. We believe that our differences enable us to be a better team – one that makes better decisions, drives innovation, and delivers better business results.

About Boys Town:

Boys Town has been changing the way America cares for children and families since 1917. With over a century of service, our employees have helped us grow from a small boardinghouse in downtown Omaha, Nebraska, into one of the largest national child and family care organizations in the country. With the addition of Boys Town National Research Hospital in 1977, our services branched out into the health care and research fields, offering even more career opportunities to those looking to make a real difference.

Our employees are our #1 supporters when it comes to achieving Boys Town's mission, which is why we are proud of their commitment to making the world a better place for children, families, patients, and communities.  A unique feature for employees and their dependents enrolled in medical benefits are reduced to no cost visits for services performed by a Boys Town provider at a Boys Town location.  Additional costs savings for the employee and their dependents are found in our pharmacy benefits with low to zero-dollar co-pays on certain maintenance drugs.   Boys Town takes your mental health seriously with no cost mental health visits to an in-network provider.  We help our employees prepare for retirement with a generous match on their 401K or 401K Roth account. Additional benefits include tuition assistance, parenting resources from our experts and professional development opportunities within the organization, just to name a few. Working at Boys Town is more than just a job, it is a way of life.

This advertisement describes the general nature of work to be performed and does not include an exhaustive list of all duties, skills, or abilities required. Boys Town is an equal employment opportunity employer and participates in the E-Verify program. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and/or expression, national origin, age, disability, or veteran status. To request a disability-related accommodation in the application process, contact us at View phone number on swooped.co.