Inpatient Coder - Work at Home - Any State

Mercy Health BSMH • Amberley, OH

4d • Remote

About The Position

Everyone who works with Mercy Health is united under one purpose: to help our patients be well in mind, body and spirit. This drive, along with our history of faith, is a powerful combination. It gives us a shared calling to work toward every day. Join our exceptional team and help us continue to provide the highest quality of health care possible to our communities.
Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, CPT IV codes, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes 3M 360 in accordance with established workflow. Follows Ensemble policies and procedures and maintains required quality and productivity standards.

Requirements

• RHIA, RHIT, CCS, CIC, or CCA

Responsibilities

• Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, leading to the assignment of the correct Medicare Severity-Diagnosis Related Group, (MS-DRG) or All Patient Refined Diagnosis Related Group, (APR-DRG.) The Inpatient Coding Specialist is responsible for verification of the patient's discharge disposition and to ensure the appropriate present on admission, (POA) indicators are assigned to each code. The assigned codes must support the reason for the visit that is documented by the provider in order to support the care provided.
• Correctly abstract required data per facility specifications.
• Responsible to assist with writing appeals for Diagnosis Related Group, (DRG) denials in order to support the assigned Diagnosis Related Group, (DRG) and to address the clinical documentation utilized in the decision making process to support the validity of the assigned codes.
• Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and epremis, and as a team, ensure timely, compliant processing of inpatient accounts through the billing system.
• Collaborates with Clinical Documentation Specialists, (CDEs,) and members of the medical staff to ensure completeness of documentation in the charts so that appropriate codes, and ultimately the correct Diagnosis Related Group (DRG,) may be assigned.
• Responsible to ensure accuracy and maintain established quality, productivity standards, and key performance indicators established for 3M 360 CAC for CRS and Direct Code.
• Remain abreast of current Centers for Medicare and Medicaid Services, (CMS) requirements as well as Correct Coding Initiative, (CCI) edits, Hospital Acquired Conditions, (HAC's) and when applicable, National Coverage Determinations, (NCDs) and Local Coverage Determinations, (LCDs,) including the addition of appropriate modifiers to ensure a clean claim the first time through.
• Maintains competency and accuracy while utlizing tools of the trade, such as the 3M encoder, Computer Assisted Coding, (CAC,) Clinical Documentation Improvement System, (CDIS,) and abstracting systems, and all reference materials. Reports inaccuracies found in software applications to HIM Coding Manager/Supervisor, reports any potential unethical and/or fradulent activity per compliance policy.

Benefits

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support
• Benefits may vary based on the market and employment status.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees