Health Information Coding Analyst, Home Health & Hospice

HealthPartners•Saint Paul, MN

About The Position

Regions is seeking an experienced Home Health and Hospice Coder to support multiple sites as part of a team handling complex coding scenarios. The role analyzes each patient stay and assigns accurate ICD-10 and CPT codes, diagnoses, procedures, and other relevant data to support financial reimbursement, collect pertinent information, and produce statistical data. The description notes that some duties may be specific to inpatient or outpatient coding and may not apply to every position; candidates should contact their leader with questions about applicable duties. The position reviews and abstracts health record documentation, selects and sequences diagnoses and procedures according to applicable classification systems and reporting requirements, applies coding guidelines, and supports data quality, regulatory compliance, privacy, and confidentiality. It also involves resolving coding edits and denials, communicating with providers and clinical documentation improvement staff, using coding and office software, and participating in training and continuing professional development. Duties may vary to accommodate organizational or departmental needs.

Requirements

Graduate from an associate or bachelor’s degree program in health information, complete a coding specialist program, or successfully complete an AHIMA or AAPC coding credential exam.
3–5 years of ICD-10/CPT coding experience.
Hold one of the listed credentials: CCA, CIC, COC, CCS, CPC, HCS-D, HCS-H, CEDC, CCS-P, RHIT, or RHIA.
Knowledge of CPT-4 and ICD-10-CM/PCS coding guidelines, rules, and regulations.
Knowledge of anatomy and physiology, basic disease processes, and medical terminology.
Intermediate computer skills.
Ability to communicate information professionally, confidently, and confidentially.

Nice To Haves

Graduate from an associate or bachelor’s degree program in health information or completion of a coding specialist program.
5 or more years of ICD-10/CPT coding experience.
One of the preferred listed credentials: CCA, CIC, COC, CCS, CPC, HCS, CEDC, CCS-P, RHIT, or RHIA.
Thorough understanding of front- and back-end revenue-cycle components in physician and hospital settings.

Responsibilities

Select diagnoses and procedures requiring coding in accordance with current coding and reporting requirements.
Review provider documentation to determine principal diagnoses, comorbidities, complications, secondary conditions, and procedures; write and send queries when necessary.
Interpret coding classification conventions and nomenclature to select and sequence diagnoses, reasons for encounter, and procedures.
Assign appropriate ICD-10-CM and ICD-10-PCS codes and use technical coding principles and MS-DRG reimbursement expertise for inpatient encounters.
Assign present-on-admission values, extract required information from source documentation, and enter it into encoder and abstracting systems.
Identify hospital-acquired conditions and report them through established procedures when required.
Review documentation and correct patient discharge disposition when necessary.
Apply official ICD-10-CM/PCS and CPT/HCPCS Level II coding guidelines and comply with internal and external requirements.
Meet or exceed departmental quality and productivity standards.
Work with clinical documentation improvement specialists and help them understand applicable coding principles and rules.
Participate in continuing education and professional development, including professional organizations, coding round tables, literature reviews, and workshops.
Assist with training new employees and attend coding department meetings.
Select inpatient principal diagnoses, procedures, complications, comorbidities, and other reportable conditions according to UHDDS definitions and coding guidance.
Evaluate the effect of code selection on DRG assignment, verify DRG assignment under IPPS definitions, and assign admission source and discharge disposition.
Work with team leads to resolve coding denials, claim edits, and other coding issues.
Abstract outpatient encounters, including reasons for encounter, secondary conditions, procedures, modifiers, medical necessity, facility levels, and applicable E&M and ICD-10 codes.
Apply OPPS reporting requirements and review documentation for emergency room facility charges, procedures, IV and infusion services, and staff, teaching, and shared services.
Assess coded-data quality, educate healthcare providers about reimbursement methodologies and coding documentation rules, and review health records for coding quality and completeness.
Review abstracted data elements for database integrity and resolve coding edits, including CCI, MCE, and OCE edits.
Use common office software and specialized coding software to complete work.
Apply policies for access to and disclosure of personal health information; follow AHIMA ethical standards; recognize and report privacy issues; and protect data integrity and validity.
Evaluate patient-record accuracy and completeness under organizational policies and external regulations, and recognize and report compliance concerns.
Perform other duties as assigned.