[Hiring] Senior Hospital Inpatient Coder @Capital Health (US)

Role Description

CANDIDATES MUST RESIDE IN THE NEW JERSEY/PENNSYLVANIA AREA.

The Hospital Coder Inpatient Senior Coder is an expert-level coding professional responsible for:

• Accurately reviewing and coding complex inpatient medical records using ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and appropriate MS-DRG/APR-DRG grouping methodologies.
• Serving as a subject matter expert within the coding department.
• Performing second level reviews and mentoring staff.
• Collaborating with Clinical Documentation Improvement (CDI), quality, and revenue cycle teams to ensure optimal reimbursement and compliance with regulatory guidelines.

Qualifications

• High School diploma or equivalent; Associate's degree preferred.
• Certified Coding Specialist (CCS) required.
• Four years medical or hospital coding experience.
• Prior experience with an encoder and EMR computer systems.
• Excellent organizational, interpersonal, verbal, and written communication skills.
• Instructed in DRG assignment and application of requirements needed to comply with federal and local regulations.
• Ability to effectively manage multiple projects simultaneously and respond quickly in a fast-paced environment.

Requirements

• Usual Work Day: 8 Hours
• Does this position formally supervise employees? No

Essential Functions

• Responsible for accurately reviewing and coding complex inpatient medical records.
• Acts as lead resource on new regulatory updates, ICD-10 CM and Procedure code changes, and reimbursement methodologies.
• Assists with analyzing coding data to identify trends, opportunities for improvement, and potential risk areas.
• Scrutinizes medical record documentation to identify trends, knowledge gaps, and documentation deficiencies.
• Verifies accurate assignment of diagnoses and procedures within the medical record to comply with federal and state regulations.
• Participates in creating a collaborative environment to promote excellence in coding and outcomes.
• Supports provider education and collaborates with revenue cycle team.
• Provides internal monitoring of coding and related data and feedback to inpatient coding staff and leadership.
• Assists in developing and maintaining coding policies, reference materials, and workflow improvements.
• Supports preparation for external audits and ensures corrective actions are implemented.
• Develops and delivers departmental specific training sessions and coding updates.
• Researches complex coding scenarios and payer rules; communicates updates to the team.
• Assists in the management of the DNFB to ensure minimal number of uncoded days.
• Maintains coding credentials and up-to-date knowledge of inpatient coding changes.
• Provides guidance in daily workflow, prioritization, and problem resolution.
• Adapts to changing department demands required to maintain high level of performance.
• Performs other duties as assigned.

Physical Demands and Work Environment

• Frequent physical demands include:
• Occasional physical demands include: Standing, Walking, Push/Pull, Twisting, Bending, Reaching forward, Reaching overhead, Talk or Hear.
• Continuous physical demands include: Sitting, Wrist position deviation, Pinching/fine motor activities, Keyboard use/repetitive motion.
• Lifting Floor to Waist: 15 lbs. Lifting Waist Level and Above: 10 lbs.
• Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate Hearing.

Benefits

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA)
• Retirement Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time-Off Program