[Hiring] Medical Coder @Luminis Health

Role Description

The Inpatient Medical Coder under the supervision of the Manager of Coding and Data Quality accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics, and compliance with federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems.

• Analyzes inpatient cases, identifies and assigns ICD-10 diagnostic and PCS procedural codes for reimbursement, research, and compliance with federal and state regulations.
• Demonstrates comprehensive knowledge of coding nomenclature to ensure accurate MS-DRG MCC/CC and APR-DRG/SOI/ROM and POA assignments.
• Utilizes critical thinking to analyze and evaluate documentation issues with consultation from medical and clinical staff, and clinical documentation specialists as needed.
• Sends coding queries to providers and communicates with CDIS when provider queries are clinical in nature.
• Monitors assigned work daily to facilitate the billing process within established timeframes.
• Codes and abstracts records within timeframes established for each patient type.
• Maintains a high level of accuracy in code assignments to prevent claim denials, billing errors, and potential legal issues.
• Receives routine feedback on metrics.
• Reviews medical records, including patient histories, examination findings, diagnoses, and treatment plans to extract pertinent information for code assignments.
• Communicates with various departments within the hospitals regarding billing and registration issues.
• Refers any problems to management timely, providing clear details.
• Complies with AHIMA standards of ethical coding and coding compliance guidelines, including adherence to HIPAA privacy regulations.
• Utilizes coding references, software tools, and electronic health records (EHR) to facilitate accurate and efficient code assignments.
• Participates in ongoing education, training, and certification programs to enhance coding proficiency and maintain credentials.
• Participates in bi-monthly meetings related to DRG mismatches with CDIS.
• Demonstrates support and compliance with Luminis Health Medical System mission, vision, values statement, goals and objectives, and policies.
• Performs other duties or projects such as coding corrections assigned by the manager.

Qualifications

• High School graduate or equivalent.
• Formal ICD-10-CM and CPT training required.
• Associates or Bachelor’s degree preferred.
• At least two (2) years of inpatient ICD-10-CM/ICD-10-PCS coding and abstracting experience in an acute care hospital setting required.
• Experience with assignment, MS-DRG/APR-DRG methodologies, and inpatient reimbursement guidelines preferred.
• Certification as Certified Coding Specialist (CCS) required.
• Preferred Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).

Requirements

• Strong analytical and organizational skills.
• Ability to prioritize workloads and meet deadlines.
• Excellent customer service skills.
• Ability to problem solve and work with minimal supervision.
• Familiar with basic medical terminology.
• Computer experience and typing ability.

Benefits

• Medical, Dental, and Vision Insurance.
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year).
• Paid Time Off.
• Tuition Assistance Benefits.
• Employee Referral Bonus Program.
• Paid Holidays, Disability, and Life/AD&D for full-time employees.
• Wellness Programs.
• Employee Assistance Programs and more.