Coder VI Specialist-Hospital Inpatient

Franciscan Alliance, Inc.

29d•$23 - $34•Remote

About The Position

The Coder VI Specialist- Hospital Inpatient analyzes the ICD 10 codes, suggested by computer assisted coding software, to ensure they align with official coding guidelines and the electronic medical record documentation. In collaboration with the Clinical Documentation Specialist, analyzes the circumstances of the visit to determine the most accurate diagnosis related group (DRG). This position also abstracts key data elements necessary for billing and data analysis. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Accurately reviews and codes patient records in the following clinical areas: hospital inpatient services. Reviews and analyzes the content of medical records and the autosuggested computer assisted codes (CAC) for the appropriate assignment of ICD diagnosis/procedure codes, present on admission indicators, hierarchical condition categories, complication and comorbidities in the proper sequence in accordance with official coding resources resulting in an accurate DRG assignment. Auditing the accuracy of the CAC software autosuggested codes. Reviews clinical documentation to validate accurate representation of the patient's clinical picture, treatment, and diagnoses. Identifies when documentation relevant to the coding process is missing, lacks specificity or is inconsistent and take steps to obtain the documentation. Identifies and enters data elements for abstracting. Meets defined coding accuracy standards. Meets defined coding productivity standards. Basic understanding of how natural language processing engine works. Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability. Understands how diagnosis and procedure codes, and reimbursement methodologies are used to determine reimbursement, public reporting of outcomes, quality of patient care, financial modeling, strategic planning, and marketing. Remains current with coding and industry changes through participation in educational opportunities to maintain coding credentials. Demonstrates a thorough knowledge of hospital inpatient coding guidelines, medical terminology, anatomy/physiology, and payer specific coding guidelines. Notifies coding leadership of trends and topics for education and feedback to physicians and departments. Assists with identification and implementation of process improvements, according to industry best practice standards, to make the best use of resources, decrease costs and improve coding services across the specialized service lines. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.

Requirements

High School Diploma/GED
2 years Coding
Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA)
Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA)
Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA)

Nice To Haves

Associate's Degree Health Information Management
Bachelor's Degree Health Information Management

Responsibilities

Accurately reviews and codes patient records in the following clinical areas: hospital inpatient services.
Reviews and analyzes the content of medical records and the autosuggested computer assisted codes (CAC) for the appropriate assignment of ICD diagnosis/procedure codes, present on admission indicators, hierarchical condition categories, complication and comorbidities in the proper sequence in accordance with official coding resources resulting in an accurate DRG assignment.
Auditing the accuracy of the CAC software autosuggested codes.
Reviews clinical documentation to validate accurate representation of the patient's clinical picture, treatment, and diagnoses.
Identifies when documentation relevant to the coding process is missing, lacks specificity or is inconsistent and take steps to obtain the documentation.
Identifies and enters data elements for abstracting.
Meets defined coding accuracy standards.
Meets defined coding productivity standards.
Basic understanding of how natural language processing engine works.
Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability.
Understands how diagnosis and procedure codes, and reimbursement methodologies are used to determine reimbursement, public reporting of outcomes, quality of patient care, financial modeling, strategic planning, and marketing.
Remains current with coding and industry changes through participation in educational opportunities to maintain coding credentials.
Demonstrates a thorough knowledge of hospital inpatient coding guidelines, medical terminology, anatomy/physiology, and payer specific coding guidelines.
Notifies coding leadership of trends and topics for education and feedback to physicians and departments.
Assists with identification and implementation of process improvements, according to industry best practice standards, to make the best use of resources, decrease costs and improve coding services across the specialized service lines.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.