[Hiring] Inpatient Pediatric Medical Coder @Guidehouse

Role Description

The Inpatient Pediatric Medical Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and CPT Diagnosis codes, as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager, the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS, and any other official coding guidelines established for use with mandated standard code sets. This position is full-time and 100% remote.

Duties and Responsibilities:

• Demonstrates the ability to perform quality hospital coding on Inpatient pediatric accounts including Medicare/NonMedicare, Surgical, Medical, Cardiac, moms/babies, and trauma cases.
• Maintains a working knowledge of ICD-10 PCS, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.
• Assures that all services documented in the patient’s chart are coded with appropriate ICD-10/PCS codes.
• Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity.
• Ability to maintain average productivity standards as follows: 2 IP charts per hour.
• Responsible for following facility specific policies and procedures.
• Works pending queues daily.
• Works GuideAudit review queue daily to ensure all charts in the review queue are worked and any corrections are communicated to the facility.
• Queries physicians whenever there is conflicting, ambiguous, or incomplete information in the medical record.
• Follows facility query policy and CDI reconciliation process.
• Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process.
• Coder downtime must be reported immediately to the administrative staff.
• Work directly with the IQC staff to ensure quality standards are being met for each facility.
• Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request.
• Responsible for coding or pending every chart placed in their queue within 24 hours.
• Works well with other members of the facilities coding and billing team to ensure maximum efficiency and reimbursement.
• Communicates problems or coding principle discrepancies to their supervisor immediately.
• Clocks in and out of ADP during work shift and enters billing hours into People Soft.
• Collaborate closely with client IT departments and Guidehouse IT to resolve system issues.
• Responsible for reviewing and updating Client Portal, and using the information contained on the Portal as a daily tool.
• Check email system at least every two hours during work hours.
• Must maintain current professional credentials.
• Coder is to maintain a working knowledge of all Coding Clinic Guidelines.
• Complete CE education provided by Guidehouse and turns in certificates timely.
• Maintain HIPAA compliant workstations.
• Maintain patient privacy always.
• Abide by all client policies and procedures.
• Abide by all Guidehouse policies and procedures.

Qualifications

• High School Diploma/GED or equivalent
• 5+ years of ICD-10-CM and ICD-10 PCS inpatient coding experience
• 1 year of pediatric in-patient coding
• Must hold one of the following credentials: RHIA, RHIT, CCS, CIC, or CPC

Requirements

• Epic Experience
• Excellent communication skills
• Personal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service

Benefits

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program