[Hiring] Inpatient Coder @Bon Secours

Role Description

Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, CPT IV codes, as well as assignment of the Medicare Severity Diagnosis Related Group (MS-DRG) / All Patient Refined - Diagnosis Related Group (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association (AHIMA) Coding Ethics, as well as all American Hospital Association (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes 3M 360 in accordance with established workflow. Follows Ensemble policies and procedures and maintains required quality and productivity standards.

Essential Job Functions

• Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, leading to the assignment of the correct Medicare Severity-Diagnosis Related Group (MS-DRG) or All Patient Refined Diagnosis Related Group (APR-DRG).
• Responsible for verification of the patient's discharge disposition and to ensure the appropriate present on admission (POA) indicators are assigned to each code.
• The assigned codes must support the reason for the visit that is documented by the provider in order to support the care provided.
• Correctly abstract required data per facility specifications.
• Assist with writing appeals for Diagnosis Related Group (DRG) denials to support the assigned DRG and address the clinical documentation utilized in the decision-making process.
• Monitor and work accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis, ensuring timely, compliant processing of inpatient accounts through the billing system.
• Collaborate with Clinical Documentation Specialists (CDEs) and members of the medical staff to ensure completeness of documentation in the charts.
• Ensure accuracy and maintain established quality, productivity standards, and key performance indicators established for 3M 360 CAC for CRS and Direct Code.
• Remain abreast of current Centers for Medicare and Medicaid Services (CMS) requirements, Correct Coding Initiative (CCI) edits, Hospital Acquired Conditions (HAC's), National Coverage Determinations (NCDs), and Local Coverage Determinations (LCDs).
• Maintain competency and accuracy while utilizing tools such as the 3M encoder, Computer Assisted Coding (CAC), Clinical Documentation Improvement System (CDIS), and abstracting systems.
• Report inaccuracies found in software applications to HIM Coding Manager/Supervisor and any potential unethical and/or fraudulent activity per compliance policy.

Required Licensure

• RHIA
• RHIT
• CCS
• CIC
• CCA

Benefits

• Competitive pay, incentives, referral bonuses, and 403(b) with employer contributions (when eligible).
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources, and discounts.
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders.
• Tuition assistance, professional development, and continuing education support.
• Benefits may vary based on the market and employment status.