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 to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems.
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Analyzes inpatient cases, identifies and assigns ICD-10 diagnostic and PCS procedural codes for reimbursement, research, and compliance with federal and state regulations.
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Demonstrates comprehensive knowledge of coding nomenclature to ensure accurate MS-DRG MCC/CC and APR-DRG/SOI/ROM and POA assignments.
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Utilizes critical thinking to analyze and evaluate documentation issues with consultation from medical and clinical staff, and clinical documentation specialists as needed.
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Sends coding queries to providers and communicates with CDIS when provider queries are clinical in nature.
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Monitors assigned work on a daily basis to facilitate the billing process within established timeframes.
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Codes and abstracts records within timeframes established for each patient type.
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Maintains a high level of accuracy in code assignments to prevent claim denials, billing errors, and potential legal issues.
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Receives routine feedback on metrics.
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Reviews medical records, including patient histories, examination findings, diagnoses, and treatment plans, to extract pertinent information for code assignments.
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Communicates with various departments within the hospitals regarding billing and registration issues.
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Refers any problems to management timely, providing clear details.
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Complies with AHIMA standards of ethical coding and coding compliance guidelines, including adherence to HIPAA privacy regulations.
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Utilizes coding references, software tools, and electronic health records (EHR) to facilitate accurate and efficient code assignments.
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Participates in ongoing education, training, and certification programs to enhance coding proficiency and maintain credentials.
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Participates in bi-monthly meetings related to DRG mismatches with CDIS.
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Demonstrates support and compliance with Luminis Health Medical System mission, vision, values statement, goals and objectives and policies.
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Performs other duties or projects such as coding corrections assigned by the manager.
Qualifications
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High School graduate or equivalent.
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Formal ICD-10-CM and CPT training required.
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Associates or Bachelorβs degree preferred.
Requirements
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Minimum of one (1) year of inpatient acute care coding experience or two (2) years of acute care outpatient coding experience required.
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Experience with ICD-10-CM/ICD-10-PCS, MS-DRG/APR-DRG methodologies, inpatient reimbursement, and coding guidelines is preferred.
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Must possess a Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) credential; CCS is preferred at the time of hire and, if not held, must be obtained within one (1) year of employment.
Benefits
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Medical, Dental, and Vision Insurance
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Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
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Paid Time Off
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Tuition Assistance Benefits
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Employee Referral Bonus Program
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Paid Holidays, Disability, and Life/AD&D for full-time employees
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Wellness Programs
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Employee Assistance Programs and more