Health Information Coding Analyst

HealthPartners•Saint Paul, MN

4d•$27 - $41

About The Position

Regions is hiring a Health Information Coding Analyst to support multiple sites as part of a team handling a wide variety of complex coding scenarios. The analyst completes coding analysis for individual patient stays and accurately assigns ICD-10 and CPT codes, diagnoses, procedures, and other relevant data to support appropriate financial reimbursement, collection of pertinent information, and statistical reporting. Duties vary by position; some apply specifically to inpatient coding and others to outpatient coding. The role involves reviewing clinical documentation, selecting and sequencing diagnoses and procedures, applying coding and reporting guidelines, entering information into coding and abstracting systems, assessing data quality, and supporting compliance, privacy, and ethical standards. The analyst also works with clinical documentation improvement specialists and team leads, helps educate providers, assists with training new employees, and participates in continuing education and department meetings. Other duties may be assigned.

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.
Three to five 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 complete a coding specialist program.
Five or more years of ICD-10/CPT coding experience.
Hold one of the listed preferred credentials: CCA, CIC, COC, CCS, CPC, HCS, CEDC, CCS-P, RHIT, or RHIA.
Thorough understanding of front-end and back-end revenue-cycle components in physician and hospital settings.

Responsibilities

Select diagnoses and procedures requiring coding for acute-care inpatient and outpatient services according to current coding and reporting requirements.
Review provider documentation to determine principal diagnoses, comorbidities, complications, secondary conditions, and surgical procedures; write and send queries when needed.
Interpret classification-system and nomenclature conventions, formats, instructional notes, tables, and definitions to select diagnoses, conditions, reasons for encounters, and procedures or services for coding.
Sequence diagnoses, encounter reasons, and procedures according to classification-system conventions and standard data-set definitions, including UHDDS.
Use technical coding principles and MS-DRG reimbursement expertise to assign appropriate ICD-10-CM diagnoses and procedures for inpatient encounters.
Assign present-on-admission values for inpatient diagnoses.
Extract required information from source documentation and enter it into an encoder or abstracting system.
Identify hospital-acquired conditions that affect payment and report them through established procedures when required.
Review documentation to verify and, when necessary, correct patient discharge disposition.
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 activities, including professional organizations, coding round tables, literature reviews, and relevant workshops.
Assist with training new employees and attend scheduled coding department meetings.
For inpatient services, select reportable diagnoses and procedures under UHDDS definitions and coding-clinic guidance; evaluate the effect of code selection on DRG assignment; verify DRGs under IPPS definitions; assign admission source and discharge disposition; and work with team leads to resolve coding denials.
For outpatient services, perform chart abstraction and select reportable encounter reasons, conditions, and procedures using applicable UHDDS, CPT, ICD-10-CM/PCS, and HCPCS guidance; apply OPPS requirements for modifiers, CPT/HCPCS Level II, and medical necessity; review and abstract emergency department facility and provider documentation; and work with team leads to resolve claim edits and coding denials.
Assess coded-data quality, educate providers about reimbursement methodologies and coding documentation rules, analyze records for coding quality and completeness, verify abstracted data elements, and review and resolve coding edits such as CCI, MCE, and OCE edits.
Use common software applications and specialized coding software to complete work processes.
Apply policies and procedures for accessing and disclosing personal health information; follow AHIMA ethical coding standards; recognize and report privacy issues; and protect data integrity and validity.
Evaluate patient-record accuracy and completeness under organizational policy and external standards, and recognize and report compliance concerns.
Perform other duties as assigned.