Hospital Inpatient Coding and DRG Analyst - FT - Day - HIM Facility Coding Remote

Capital Health (US)

1d•$64,626 - $84,448•Remote

About The Position

Capital Health is seeking an expert-level Hospital Coder Inpatient Senior Coder to accurately review and code complex inpatient medical records using ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and appropriate MS-DRG/APR-DRG grouping methodologies. This role serves as a subject matter expert within the coding department, performing second level reviews, mentoring staff, and collaborating with Clinical Documentation Improvement (CDI), quality, and revenue cycle teams to ensure optimal reimbursement and compliance with regulatory guidelines. The position is full-time, day shift, and remote.

Requirements

High School diploma or equivalent.
Certified Coding Specialist (CCS) required.
Four years medical or hospital coding experience.
Prior experience with an encoder and EMR computer systems.
Possesses excellent organizational, interpersonal, verbal, and written communication skills.
Instructed in DRG assignment and application of requirements needed to comply with federal and local regulations.
Ability to effectively manage multiple projects simultaneously and ability to respond quickly in a fast-paced environment.

Nice To Haves

Associate's degree preferred.

Responsibilities

Responsible for accurately reviewing and coding complex inpatient medical records using ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and appropriate MS-DRG/APR-DRG grouping methodologies.
Acts as lead resource on new regulatory updates, ICD-10 CM and Procedure code changes, and reimbursement methodologies.
Acts as the subject matter expert (SME) on DRGs.
Assists with analyzing coding data to identify trends, opportunities for improvement and potential risk areas.
Scrutinizes medical record documentation to identify trends, knowledge gaps, and documentation deficiencies.
Verifies accurate assignment of diagnoses and procedures within the medical record to comply with federal and state regulations.
Participates in creating a collaborative environment to promote excellence in coding and outcomes.
Supports provider education and collaborates with revenue cycle team to ensure optimal reimbursement and compliance with all regulatory guidelines.
Collaborates with Clinical Documentation Improvement (CDI), revenue integrity, billing, and compliance departments to ensure optimal DRG assignment.
Provides internal monitoring of coding and related data and provides detailed feedback to inpatient coding staff as well as leadership.
Assists in developing and maintaining coding policies, reference materials, and workflow improvements.
Supports preparation for external audits and ensure corrective actions are implemented.
Develops and delivers departmental specific training sessions, coding updates, and targeted education based on audit findings.
Research complex coding scenarios and payer rules; communicates updates to the team.
Assists in the management of the DNFB to ensure minimal number of uncoded days.
Maintains coding credentials and up-to-date knowledge of inpatient coding changes.
Provides guidance in daily workflow, prioritization, and problem resolution.
Adapts to changing department demands required to maintain high level of performance.
Performs other duties as assigned.