About the position
This level 3 coding position provides support to the Enterprise Coding Department for the coding of Inpatient services. The Inpatient Coder position requires certification and active credential status with AHIMA and advanced coding experience in the highly specialized areas of Inpatient coding. The position is responsible for reviewing clinical documentation and assigning the correct ICD 10 CM and ICD 10 PCS coding to Inpatient records. It utilizes Epic and Solventum 3M 360 systems and requires effective communication via email. The role involves collaboration with Coding Leads, Clinical Documentation Specialists, and the Billing Department to ensure correct coding and DRG assignment, resulting in accurate Case Mix Index calculations and reimbursement. The coder must ensure that documentation complies with ICD 10 and CMS coding guidelines and advise coding partners and new hires in coding assignments. Maintaining an hourly productivity standard and quality standards as set by Enterprise Coding and based on Industry Standards is required. Attendance at Enterprise Coding and Clinical Department meetings via conference call and WebEx is also necessary. Coding Work queue assignment will vary based on business needs or management assignment.
Responsibilities
- Inpatient Coding at 95% or above accuracy.
- Abstract information from inpatient medical records to assign correct codes following the ICD 10 guidelines.
- Identify query opportunities.
- Verify Account Class, Attending provider, and Discharge Disposition in Epic. Assign codes via Solventum 3M 360.
- Resolve with coding leads and billing any issues, coding denial requests or questions as part of the coding denial process.
- Follow team procedures necessary in carrying out ICD 10 coding on cases in the Uncoded IP accounts work queue in Epic.
- Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
- Coordinate all billing information and ensure that all information is complete and accurate.
- Maintain supportive and open communication with coding supervisor and team leads regarding coding issues and priority coding responsibilities assigned.
- Serve as a resource to inpatient coding leadership and coding team for a broad range of billing policy and procedure issues.
- Attend coding meetings and seminars and share knowledge with other coders.
- In collaboration with Leadership, make recommendations and implement remedial actions for problems.
- Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and government agencies to advise physicians of billing practice changes in ICD-10.
- Participate in Enterprise Coding education sessions, Kaizen events, maintain CEUs, and stay informed of current trends in coding.
Requirements
- High school diploma or GED.
- Minimum of 4 years professional or hospital experience reviewing, abstracting, coding in ICD 10 CM or ICD 10 PCS, or CPT.
- Certification in one of the following: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) through AHIMA, Certified Professional Coder (CPC) through AAPC, or equivalent certification.
- Active AHIMA membership may be required for some positions.
Nice-to-haves
- Accredited Coding Program, Associates or Bachelor Degree; Specialized Coding Credential.
- Knowledge of Inpatient coding guidelines, MCE and compliance edits.
- Experience using an EMR.
- Experience using EPIC, 3M encoder.
- Proficiency with word processing and Excel spreadsheets.
- Advanced knowledge of ICD-10-CM, Federal Register, Federal and State insurance billing laws and Mandates.
- Excellent verbal and written communication skills with the ability to effectively communicate with individuals at all levels, including physicians, nurses, and administrative management.
- AHIMA certification required upon hire.
- Able to pass internal coding test to qualify as a Level 3.
