[Hiring] Inpatient Hospital Reimbursement & Coding Specialist III @Erlanger Health System

Role Description

This role involves utilizing an electronic medical record and computerized encoder to assign and sequence diagnosis and procedure codes based on medical record documentation.

• Inpatient Coding:
  • Must code all types of adult and pediatric inpatient cases including long length of stays, mortality, trauma, L&D, NICU, and normal newborns.
• Outpatient Coding:
  • Must code all types of outpatient cases including ED, outpatient, OBS, Same Day Surgery.

Detailed responsibilities include:

• Reviewing inpatient or outpatient medical records to assign and sequence all appropriate diagnosis and procedure codes utilizing encoder software.
• Validating accuracy of Admission-Discharge-Transfer (ADT) data fields.
• Reviewing appropriate coding work queues daily to address coding edits and needed corrections.
• Working with Leadership to obtain additional information for incomplete or ambiguous documentation.
• Following charge verification processes and routing accounts based on missing, incomplete, or inaccurate charging.
• Adhering to Health Information Management (HIM) Coding policies.
• Interpreting and applying American Hospital Association (AHA) Official Coding Guidelines.
• Maintaining coding certification and knowledge referencing coding guidelines and regulatory changes.
• Contacting the appropriate department or physician for assistance in obtaining physician clarification.
• Participating in performance improvement initiatives as assigned.

This position must consistently meet or exceed productivity and quality standards as defined by department Leadership.

Qualifications

• Knowledge of Anatomy and Physiology, Disease Pathology, and Medical Terminology.
• Knowledge of coding conventions and use of coding nomenclature consistent with CMS Official Guidelines for Coding and Reporting ICD-10-CM coding.
• Accurate translation of written diagnostic descriptions to assign ICD-10-CM diagnostic codes.
• Accurate translation of written procedure descriptions to assign ICD 10 PCS procedure codes and CPT/HCPCs codes.
• Ability to navigate the Electronic Medical Record for coding/billing documentation.
• Knowledge of clinical content standards.

Requirements

• Validation of coding certification, i.e., specialty focus such as ICD-10-CM coding, ICD-10-PCS, CPT coding, and billing practices from an accredited program.
• 4 years of coding experience in an acute care hospital.
• Computer literate in a Windows environment, with basic word processing skills and knowledge of MS Office.
• Excellent communication skills both written and oral.
• Demonstration of sound judgment and organizational ability.
• Ability to maintain quality and quantity standards in coding.

Company Description