Inpatient Facility Coding Specialist (Data Analytics & Trending Specialist) (Coding Certificati[...]

Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: HIM - Coding Job Summary JOB SUMMARY Reviews documentation in the electronic medical record and assign and sequences ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes, in accordance with the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and in compliance with ICD-10 Official Coding Guidelines and other regulatory requirements. Uses Diagnosis Related Groups (DRG) methodologies, including Medicare Severity DRGs (MS-DRGs) and All Patient Refined DRGs (APR-DRGs). Responsible for coding mortality and high dollar (over $400k) complex discharges and will draft physician queries, to clarify documentation for optimal coding and quality reporting. . Key Responsibilities Review, analyze and interpret the entire electronic medical record for the current admission to identify all diagnoses and procedures documented during the admission. Determine and assign the principal and significant secondary ICD-10-CM diagnosis codes, in addition to present on admission indicators, and ICD-10-PCS procedure codes, using official coding guidelines and knowledge of anatomy and physiology, pharmacology and pathophysiology/disease processes. Identify cases with clinical indicators that may require provider documentation clarification and/or specificity to accurately assign codes; collaborate with CDIS team as part of the clinical documentation validation and physician query workflows. Analyze code assignment and sequence to assure proper DRG assignments; sequence codes in compliance with ICD-10 Official Coding Guidelines, Uniform Hospital Discharge Data Set (UHDDS) and other regulatory requirements to accurately assign the DRG. Analyze the medical record documentation for complications and comorbidities. Analyze medical record documentation for optimum severity of illness and risk of mortality scores. Confirm Admission-Discharge-Transfer (ADT) information and correct when necessary. Technical Capabilities COMPLIANCE (Advanced): Understanding the rules, regulations, sanctions and other statutory requirements, guidelines and instructions relating to governing bodies and organizations, both internally and externally. MEDICAL TERMINOLOGY & DOCUMENTATION (Expert): The ability to comprehend medical terminology and documentation in an office, or surgical setting. CRITICAL THINKING (Advanced): The objective analysis and evaluation of an issue in order to form a judgment. MEDICAL CODING (Expert): The transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. WRITTEN COMMUNICATION (ADVANCED): Demonstrates the ability to write clear, detailed, and comprehensive status reports, memos and documentation. Demonstrates an understanding of effective composition, such as having first line in a paragraph state the subject. Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more. At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose. Position Qualifications Responsibilities: Certifications: Certified Coding Associate - American Health Information Management Association (AHIMA), Certified Coding Specialist - American Health Information Management Association (AHIMA), Certified Coding Specialist - Physician - American Health Information Management Association (AHIMA), Certified Outpatient Coder - American Academy of Professional Coders, Certified Professional Coder - Outpatient - American Academy of Professional Coders, Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) Work Experience: Relevant Work Experience Experience Level: 5 years Education: High School Diploma or GED (Required) Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. 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