Medical Coder

The Hospital Inpatient Coding Specialist reviews inpatient medical records and assigns International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10 CM) diagnosis and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10‑PCS) procedure codes that derives an All Patient Refined Diagnosis Related Group (APR‑DRG) or Medical Severity Diagnosis Related Group (MS‑DRG) for optimal reimbursement. The Hospital Inpatient Coding Specialist will work in collaboration with the Clinical Documentation Integrity Specialist at times to ensure accuracy consistent with Centra’s coding policies. The Hospital Inpatient Coding Specialist will abstract pertinent information according to established guidelines for the organization and will formulate provider queries to clarify information.

Responsibilities

• Assigns diagnosis and procedure codes.
• Verifies accuracy of DRG
• Accurately abstracts required information.
• Initiates provider coding queries in compliance with coding guidelines and policies where appropriate.
• Meets productivity standard of 2 charts per hour or higher.
• Meets coding accuracy of 95% or higher.
• Verifies and assigns discharge status codes.
• Ensures presence of a completed Medicaid certification prior to finalizing coding.
• Appropriately assigns the Hospital Acquired condition (HAC) and Present on Admission (POA) indicator for each diagnosis.
• Communicates with Clinical Documentation Integrity (CDI) Specialist via email, phone, or other methods regarding accounts.
• Participates in team, organization and educational meetings.
• Maintains and continually enhances coding competency, through participation in educational programs, reading official coding publications such as the American Hospital Association’s (AHA) Coding Clinic for ICD-10-CM/PCS, AHA Coding Clinic for HCPCS, AMA CPT Assistant) to stay abreast of changes in codes, coding guidelines, regulatory and other requirements.
• Maintains coding credential(s) by completing continuing education requirements of credits per year.
• Assists in achieving department goals of Accounts Receivable days in regard to Discharged Not Final Billed (DNFB).

Other Functions

• Observes confidentiality and safeguards all patient related information.
• Remote home office skills including PC use and maintenance, knowledge of Microsoft Office products including Excel and Outlook.
• Communicates in a positive and professional manner with patients, providers, and staff.
• Demonstrates ability to work independently.
• Demonstrates ability to adjust to changes in workflow.
• Thoroughness and attention to detail.
• Performs other duties as assigned.

Qualifications

• Required Qualifications:
  • High School Diploma or equivalent
  • One or more of the following certifications required: RHIA, RHIT, CCS or CCA
  • Minimum of 2 years acute care inpatient coding experience required.
  • Experience in coding across multiple specialties within a hospital coding environment and remote coding experience preferred.
  • Demonstrated proficiency in ICD-10-CM and ICD-10-PCS by passing coding competency assessment administered before hire.
  • Demonstrated proficiency in medical terminology, anatomy and physiology, and disease process by passing coding competency assessment administered before hire.
  • Good working knowledge of Inpatient Prospective Payment System (RPPS), Diagnosis Related Group (DRG) methodologies, Severity of Illness (SOI), and Risk of Mortality (ROM)
• Preferred Qualifications:
  • Bachelor’s degree- Healthcare

Travel Required

Travel is expected to be between 0%-10% of the time.