Coder III

MaineGeneral Health•Waterville, ME

6d•Onsite

About The Position

Assigns diagnosis, procedure, and DRG codes for inpatient accounts to ensure quality documentation and accurate reimbursement for services provided. Reviews complex documentation from records to identify appropriate diagnostic and procedural codes (ICD, PCS, CPT). Uses coding guidelines, clinics, LCDs and NCDs, and other resources and clinics to accurately assign and sequence appropriate codes and assign DRG. Identifies any quality concerns and refers to the quality department as indicated. Reviews CDI documentation and collaborates closely with CDI staff to ensure accurate DRG/AAPC assignment. Justifies DRG/AAPC discrepancies. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding and optimize DRG and severity of illness documentation.

Requirements

Certification by the American Health Information Management Association (AHIMA) or by the American Academy of Professional Coders (AAPC) required.
At least one year of inpatient coding experience is strongly preferred.

Responsibilities

Assigns diagnosis, procedure, and DRG codes for inpatient accounts.
Reviews complex documentation from records to identify appropriate diagnostic and procedural codes (ICD, PCS, CPT).
Uses coding guidelines, clinics, LCDs and NCDs, and other resources to accurately assign and sequence appropriate codes and assign DRG.
Identifies any quality concerns and refers to the quality department.
Reviews CDI documentation and collaborates closely with CDI staff to ensure accurate DRG/AAPC assignment.
Justifies DRG/AAPC discrepancies.
Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding and optimize DRG and severity of illness documentation.