Coder III

Augusta Health • Fishersville, VA

56d

About The Position

Under the direction of the Health Information Management Director and the Coding Manager, the Coder III follows all regulatory guidelines in the reporting and sequencing of ICD-10-CM and PCS codes for all patient accounts, generates coding queries to physicians to clarify patient condition(s) when conflicting or ambiguous information is reflected in the patient record, understands their role in quality performance measures, and serves as a resource to the Business Office in the reconciliation and resolution of problematic accounts. This position plays a critical role in supporting Augusta Health's mission and advancing departmental goals through measurable performance indicators and service excellence. This position contributes to a collaborative, patient-centered environment and helps drive outcomes aligned with organizational priorities.

Requirements

• Education: High School Diploma or GED equivalent
• Licensure/Certification: CCS or CPC
• Experience: Inpatient Coder - minimum of three years hospital inpatient coding experience.
• Driver's License: N/A
• Eligibility to work in the United States and meet Virginia state employment requirements
• Requires good written, oral communication and interpersonal skills. ability to effectively communicate with all hospital practitioners is essential.
• Demonstrates competency in the use of computer applications and grouper software, Medicare edits, and all coding and abstracting software and hardware currently in use by HIM.
• Requires comprehensive knowledge of anatomy and physiology, medical terminology and disease processes.
• Requires analytical ability to allow for interpretation of clinical data in all clinical specialties to determine appropriate code assignment.
• Requires proficiency in abstracting chart data into computer module.
• Requires ability to work independently, an eagerness to learn, attention to detail and good critical thinking skills.
• Must possess high ethical standards due to confidential nature of patient information.

Nice To Haves

• Education: Associate's Degree in Health Information Mgmt (HIM)
• Licensure/Certification: CCS, RHIT, RHIA CCA, COC, CIC, CPA-A
• Experience: Three years inpatient coding experience.
• Prior experience in a hospital, healthcare system, or related service-oriented environment
• Familiarity with Augusta Health's systems, workflows, or organizational culture is a plus
• CCS, RHIT, RHIA CCA, COC, CIC, CPA-A
• Three years inpatient coding experience.

Responsibilities

• Accurately enter ABS data (e.g. Surgeon name, procedure date, discharge disposition, admit diagnosis, POA status, etc.) 95% + Accuracy
• Meets or exceeds bill drop dates/AR expectations
• Consistently monitors and manages AR to facilitate dropping of pending, old, or problematic accounts of assigned locations in accordance with 30-Day Bill Drop policy.
• Consistently meets established bill drop dates.
• Percentage of weeks in which bill drop dates are met: 90% of the time
• Accurately reports principal diagnosis in keeping with the most current AHA Coding Clinic and ICD-10-CM/ICD-10PCS guidelines. 95% + Accuracy
• Works with Coding Manager and Denial Management Coordinator to ensure all coding denials are addressed timely.
• Manages Queries Appropriately
• Generates appropriate query selection based on clinical evidence established in the patient medical record.
• Formats non-standardized queries in keeping with AHA Coding Clinic, CMS, and QIO guidelines.
• Utilizes standardized query templates when available.
• Maintains established Productivity Standards
• Inpatient encounters: an average of 2 accounts per hour.
• Meets or exceeds the expected DRG/APC accuracy rate of 95%
• Diagnosis and procedural codes applied to accounts result in the appropriate DRG or APC assignment(s)
• Accurately reports procedure codes
• All ICD-10-CM and CPT procedure codes are accurately coded and reported in keeping with AHA Coding Clinic, CPT Assistant, ICD-10-CM, CPT-4, and/or unique payer coding and reporting guidelines. 95% + Accuracy
• Accurately reports secondary diagnoses in keeping with the most current AHA Coding Clinic and ICD10-CM/ICD-10-PCS guidelines. Inpatient: 95% + Accuracy

Benefits

• Comprehensive insurance package including medical, dental, and vision coverage
• Retirement savings plans and financial wellness support programs
• Generous paid time off and flexible scheduling to promote work-life balance
• Career development programs including clinical ladders, shared governance, and advancement opportunities
• Personalized onboarding with dedicated preceptors and ongoing educational support
• Tuition reimbursement and access to onsite childcare
• Free onsite parking, 24/7-armed security for your safety, a Health Fitness Reimbursement Program, and an onsite credit union and pharmacy
• Competitive pay with shift/weekend differentials
• Employee discounts at the cafeteria, gift shop, pharmacy, and local entertainment venues (i.e., movie tickets)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees