Coding Specialist - Inpatient Telecommute

Summary Under the general supervision of the Health Information Coding Manager, the incumbent reviews inpatient medical records to assign appropriate ICD‑10‑CM/PCS codes in accordance with the Official Guidelines for Coding and Reporting. They determine appropriate MS‑DRG or APR‑DRG assignment for optimal classification and accurate, compliant clinical reporting, identify and recommend physician queries when documentation is incomplete, ambiguous or unclear, and maintain HIS quality and productivity standards. Brown University Health employees are expected to role‑model the organization’s values of Compassion, Accountability, Respect, and Excellence, guiding everyday actions with patients, customers and one another while demonstrating the core Success Factors of Instilling Trust and Value Differences and Patient and Community Focus and Collaboration. Responsibilities Enters into a written Telecommuting Agreement with department management, agreeing to be accessible by telephone/email during the agreed upon work schedule, maintain accurate work‑and‑rest period records, and submit weekly work hours in accordance with Brown University Health’s written Telecommuting policy. Reads and comprehends inpatient medical records, identifying all treated diagnoses and procedures, and reports the correct code(s) adhering to Official Coding Guidelines. Performs coding validation on codes computer‑assisted and auto‑suggested by 3M. Understands clinical documentation to recognize when a query to the physician is required. Maintains working knowledge of clinical documentation such as lab results identifying respiratory failure, uncontrolled diabetes, and performs internet searches when fuller understanding of disease processes and medications is needed. Coding simple inpatient medical records typically seen in community hospitals, excluding Level1 trauma cases and complex surgical cases. Reviews internet videos for full understanding of procedures to ensure coding accuracy. Navigates the electronic medical record, ensuring documentation supports the codes selected for principal diagnosis, secondary diagnoses, complications, comorbid conditions, procedures and discharge disposition. Abides by the Standards of Ethical Coding set forth by the American Health Information Management Association and enters abstracted information or validates codes into the 3M DRG grouper. Assigns accurate MS‑DRG or APR‑DRG, adds Present‑On‑Admission (POA) indicators, identifies Hospital Acquired Condition and Patient Safety Indicator codes, and forwards them to the designated review process. Selects the physician performing procedures to ensure accuracy in the hospital’s billing system, works closely with the Clinical Documentation Specialist for additional review, responds promptly to coding validator recommendations, and prioritizes high‑paying records for completion the day received. Performs concurrent coding for in‑house patients requiring interim billing, meets coding productivity, quality and accuracy standards, may be required to code rehabilitation records per established process, and consistently meets established productivity standards. Follows up on all billing holds to ensure timely billing and reimbursement, acts as a resource to physicians and staff on coding principles, DRG assignments and outpatient coding issues, refers coding, billing and system questions to the coding manager or validator, and seeks supervisory assistance only after exhausting own resources. Assists other coders by providing guidance to entry‑level coders, keeps abreast of coding guidelines and reimbursement reporting requirements, maintains credentials, upholds health information confidentiality, and performs related clerical duties as assigned. Minimum Qualifications Basic Knowledge Associate degree required; preferred in Health Information Technology (ideally RHIT or RHIA) and AHIMA CCS Certified Coding Specialist credential. If the associate degree is not in health information technology, successful completion of an inpatient coding certification program accredited by AHIMA or the AAPC credential CIC, Certified Inpatient coder. Good writing skills to prepare compliant physician queries. Computer literate; capable of researching internet websites to clarify diseases or procedures. Ability to navigate the patient electronic medical record to access and recognize appropriate data applicable to the coding process. Experience Three to five years of inpatient coding experience in a teaching or acute‑care hospital, with proven ability to understand the clinical content of a health record. Trained in medical terminology, anatomy and physiology, and able to recognize and understand clinical documentation pertinent for coding. Good writing skills to prepare compliant physician queries. Computer literate; capable of researching internet websites to clarify diseases or procedures. Ability to navigate the patient electronic medical record to access and recognize appropriate data applicable to the coding process. Working Conditions Reads electronic medical records for the entire workday using dual computer monitors, sits for long periods, lifts a minimum of 25 pounds, bends, stoops, stretches, and uses step‑stools to file records. Works under stressful conditions to maintain accounts receivable days while achieving productivity and accuracy. Independent Action Performs work independently within department policies and practices, referring specific complex problems to the supervisor when clarification of departmental policies and procedures is required. No Supervisory Responsibility None. Pay Range $26.27 – $43.34 per hour. EEO Statement Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Location Corporate Headquarters – 15 LaSalle Square, Providence, Rhode Island 02903. Work Type Monday–Friday; weekends and holidays as scheduled. Work Shift Variable. Daily Hours 8 hours. Driving Required No. #J-18808-Ljbffr