Inpatient Coder II, HB coding

Northwestern Memorial Healthcare • Chicago, IL

3d

About The Position

The Inpatient Coder II is the coding and reimbursement expert for ICD-10-CM diagnosis coding and ICD-10-PCS procedure coding for complex inpatient acute care discharges. The role requires a strong foundation in coding conventions, instructions, Official Guidelines for Coding and Reporting, and Coding Clinics, along with a deep understanding of disease processes, anatomy and physiology, pharmacology, and medical terminology. The position adheres to Northwestern Medicine’s mission, vision, values, Code of Ethics, Corporate Compliance Program, applicable policies and procedures, and regulatory and accreditation standards.

Requirements

• RHIA, RHIT, or CCS credential.
• AHIMA membership.
• At least 3 years of inpatient coding experience in an acute healthcare setting.
• Strong knowledge of coding conventions, instructions, Official Guidelines for Coding and Reporting, and Coding Clinics.
• Knowledge of disease processes, anatomy and physiology, pharmacology, and medical terminology.

Nice To Haves

• Associate’s degree in a related field.
• RHIA or RHIT with CCS, CDIP, or CCDS credential.
• 4 years of inpatient coding experience in a teaching hospital.

Responsibilities

• Assign appropriate ICD-10-CM and ICD-10-PCS codes to complex inpatient visit types using technical coding expertise.
• Assign Present on Admission (POA) values to secondary diagnoses for quality metrics and reporting, using expertise in clinical disease processes and documentation.
• Review provider notes and findings from the Clinical Documentation Improvement (CDI) Department’s concurrent review.
• Use Computerized Assisted Coding (CAC) software resources, including autosuggestion and annotation features, to review documentation and select or assign codes efficiently.
• Review discharge planning and nursing documentation to validate and correct, when necessary, the discharge disposition affecting Medicare Post-Acute Transfer Policy reimbursement.
• Apply knowledge of MS-DRGs, APR-DRGs, and AHRQ Elixhauser risk adjustment to sequence appropriate ICD-10-CM codes within the top 24 fields for reimbursement and organizational ranking purposes.
• Collaborate with CDI on approximately 45% of discharges regarding final MS-DRG or APR-DRG assignment and comorbidity diagnoses.
• Educate CDI on regulatory guidelines, Coding Clinics, and conventions for reporting appropriate ICD-10-CM diagnoses.
• Interpret health record documentation to determine the principal diagnosis, secondary diagnoses, and procedures.
• Follow ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting, Coding Clinic guidance, coding conventions, and instructional notes when assigning diagnoses and procedures.
• Write appeal letters in response to payor DRG downgrade notices.
• Resolve Nosology Messages/Alerts and Coding Validation Warnings/Errors.
• Meet established coding productivity and quality standards.

Benefits

• Competitive benefits, including tuition reimbursement, loan forgiveness, and 401(k) matching.
• Benefits intended to support employees’ physical, emotional, and financial well-being and provide protection for unexpected life events.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed