Inpatient Coder II, HB coding

The Inpatient Coder II reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.

The Inpatient Coder II is the coding and reimbursement expert for ICD-10-CM diagnosis coding and ICD-10-PCS procedure coding for complex inpatient acute care discharges. Possesses a strong foundation in coding conventions instructions Official Guidelines for Coding and Reporting and Coding Clinics. Has a deep understanding of disease process anatomy/physiology pharmacology and medical terminology.

RESPONSIBILITIES:

* Utilizes technical coding expertise to assign appropriate ICD-10-CM and ICD-10-PCS codes to complex inpatient visit types. Complexity is measured by a Case Mix Index (CMI) and Coder IIs typically see average CMIs of 2.2609. This index score demonstrates higher patient complexity and acuity.

* Utilizes expertise in clinical disease process and documentation to assign Present on Admission (POA) values to all secondary diagnoses for quality metrics and reporting.

* Thoroughly reviews the provider notes within the health record and the Findings from the Clinical Documentation Nurse in the Clinical Documentation Improvement (CDI) Department who concurrently reviewed the record and provide their clinical insight on the diagnoses.

* Utilizes resources within CAC (Computerized Assisted Coding) software to efficiently review documentation and select or assign ICD-10-CM/PCS codes using autosuggestion or annotation features.

* Reviews Discharge Planning and nursing documentation to validate and correct when necessary the Discharge Disposition which impacts reimbursement under Medicares Post-Acute Transfer Policy.

* Utilizes knowledge of MS-DRGs APR-DRGs AHRQ Elixhauser risk adjustment to sequence the appropriate ICD-10-CM codes within the top 24 fields to ensure correct reimbursement and NMs ranking in US News and World Report.

* Collaborate with CDI on approximately 45% of discharges regarding the final MS or APR DRG and comorbidity diagnoses.

* Educates CDI on regulatory guidelines Coding Clinics and conventions to report appropriate ICD-10-CM diagnoses.

* Interprets health record documentation using knowledge of anatomy physiology clinical disease process pharmacology medical terminology to determine the Principal Diagnosis secondary diagnoses and procedures.

* Follows the ICD-10-CM Official Guidelines for Coding and Reporting ICD-10-PCS Official Guidelines for Coding and Reporting Coding Clinic for ICD-10-CM and ICD-10-PCS coding conventions and instructional notes to assign the appropriate diagnoses and procedures.

* Utilizes coding expertise and knowledge to write appeal letters in response to payor DRG downgrade notices.

* Resolves Nosology Messages/Alerts and Coding Validation Warning/Errors.

* Meets established coding productivity and quality standards.

Qualifications :

Minimum Requirements:

Certification:  

• RHIA RHIT or CCS credential 

• AHIMA membership 

Experience:   

• 3 years of inpatient coding experience in an acute healthcare setting 

Preferred:

• Associates degree in related field
• RHIA RHIT with CCS or CDIP/CCDS credential
• 4 years of inpatient coding experience in a teaching hospital

Additional Information :

Northwestern Medicine is an equal opportunity employer (disability VETS) and does not discriminate in hiring or employment on the basis of age sex race color religion national origin gender identity veteran status disability sexual orientation or any other protected status. 

Background Check 

Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and at times internal transfers. If you are offered a position with us you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis and we follow all local state and federal laws including the Illinois Health Care Worker Background Check Act. 

Artificial Intelligence Disclosure  

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position however all employment decisions will be made by a person.

Benefits 

We offer a wide range of benefits that provide employees with tools and resources to improve their physical emotional and financial well-being while providing protection for unexpected life events. 

Click on or copy and paste URL to your browser to view detailed benefits information refer to the Benefits Eligibility by Employment Classification to determine benefits eligibility for job postings.

If sign-on bonus is included in a job posting eligibility is as followed: Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign-on bonus. Exception: New graduate internal employees seeking their first licensed clinical position as a Registered Nurse at NM may be eligible.

Remote Work :

Yes

Employment Type :

Full-time