Mid-Level Inpatient Coding Specialist

Mid-Level Inpatient Coding Specialist

Queries physicians for clarification of discrepancies, additional diagnoses, complications, or co-morbid conditions as needed. Applies ICD-10-CM/PCS codes, MS-DRG codes, Present on Admission codes, and patient status codes, understanding their impact on mortality rates, clinical quality, reimbursement, internal scorecards, and key performance indicators. Utilizes a thorough understanding of the Official Coding Guidelines, Coding Clinic guidance, medical necessity, and coverage determinations. Uses critical thinking and sound judgment in decision-making, balancing reimbursement considerations with regulatory compliance. Reviews encounters for proper admission source, discharge disposition, and assigns the operative physician and date of procedure to the chart coding screen. Works with other Coding team members to keep coding within two days of discharge and hospital coding days within three days. Completes coding for multiple facilities in a timely manner. Other duties as assigned. Reviews, analyzes, and interprets clinical documentation to apply appropriate ICD-10-CM/PCS coding conventions and MS-DRG Medicare Prospective Payment System requirements. Evaluates and optimizes various DRG options in accordance with UHDDS rules, official coding guidelines, regulatory agencies, and approved policies. Verifies CAC codes and ensures diagnostic and procedure codes are supported by the physician's clinical documentation. Communicates with physicians and allied health personnel to ensure comprehensive, accurate, and timely clinical documentation. Discusses optimization and documentation issues with physicians and clinical personnel to ensure optimal coding and reimbursement.

Knowledge, Skills, and Abilities:

• Thorough knowledge of Medicare reimbursement methodology, documentation guidelines, data abstraction, and encoder functionality.
• Ability to communicate effectively with physicians and physician office staff.
• Computer skills, including Microsoft Office and Encoder software.
• Self-motivated and able to work independently in a remote setting.
• Critical thinking and problem-solving skills.
• Comprehensive knowledge of coding functions, rules, and guidelines as it relates to DRG assignment.
• Thorough knowledge of medical terminology, anatomy and physiology, and pathophysiology.

Education:

• Associate [Preferred]
• High School Grad or Equiv [Required]

Field of Study: Associate degree in Health Information Managment or medical coding certification required

Work Experience:

• 3+ of inpatient hospital coding experience, including cases requiring specialized coding skills, such as cardiovascular surgery, neurosurgery, trauma surgery, neonatology, pediatrics, plastic and reconstruction surgery, bariatric surgery, cardiology, and other services and procedures provided in a tertiary care facility. [Required]
• Extensive experience with cases requiring more complex coding skills, such as advanced cardiovascular, cardiothoracic, neurological, and orthopedic surgical procedures, extended or prolonged length of stays (> 100 days), BMT and other solid organ transplantations, ECMO, cutting-edge surgical advancements that are considered new and innovative, procedures that may be considered experimental or research-based, and other complicated treatments or procedures provided in a quaternary care facility. [Preferred]

Licenses and Certifications:

• Registered Health Information Administrator (RHIA) [Required] OR
• Registered Health Information Technician (RHIT) [Required] OR
• Certified Coding Specialist (CCS) [Required] OR
• Certified Professional Coder (CPC) [Required]

Physical Requirements: (Please click the link below to view work requirements) Physical Requirements

Pay Range:

$21.73 $40.42

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

AdventHealth Corporate