Inpatient Coding Specialist

CGH Medical Center

1d•$21 - $31•Onsite

About The Position

Reviews the contents of moderate to highly complex medical records, assigns appropriate ICD-10-CM and ICD-10-PCS codes, abstracts pertinent data for claims processing, data retrieval and analysis. Abides by the Standards of Ethical Coding as set forth by the American Health Information Association and adheres to official coding and reporting guidelines and hospital-specific guidelines. Maintains knowledge of pertinent federal regulations related to inpatient coding and reimbursement. For coding purposes, routinely communicates with providers when documentation in the medical record is inadequate, ambiguous, or unclear.

Requirements

3 years coding experience in a medical center required.
Basic PC and PC maintenance skills required.

Nice To Haves

IP coding experience
CPT procedure coding
CPC, CCS, CCS-P credential preferred; CCS or CCS-P must be successfully completed within 2 years of hire.
Working knowledge of regulatory requirements, MS-DRG, APR-DRG, POA assignment, understanding of APC’s, modifiers and accounts receivables preferred.

Responsibilities

Reviews the contents of the medical record to identify the diagnoses and procedures to be code ensuring that all conditions, operations, and procedures, and assignment of POA (Present on Admission) indicators are properly documented by the provider and sequenced properly.
Demonstrated ability to independently comprehend the clinical content of a medical record, including the most complex records, and utilize the encoder to properly assign ICD-10-CM and ICD-10-PCS codes to provide an accurate MS-DRG and APR-DRG, identify POA indicators, and sequence codes, in support of the hospital revenue cycle and to ensure optimal reimbursement.
Evaluates potential coding and medical necessity issues identified by edits shown in the encoder and resolves issues utilizing the Uniform Hospital Discharge Data Set Guidelines, the ICD-10-CM and ICD-10-PCS Official Coding Guidelines for Coding and Reporting, and Coding Clinic guidelines to allow accurate, timely billing.
Utilize coding knowledge and auditing skills related to coding, quality, and compliance, to perform record reviews requested by RAC Coordinator or Revenue Integrity Coordinator in conjunction with RAC audits, insurance-requested records for potential risk, etc.
Compares documentation in the medical record with associated specific charges in billing system (Cerner and/or Sapphire), for targeted areas, to assure compliance and charging accuracy prior to billing.
Participates actively in the Revenue Cycle by regularly monitoring the Prebill report and completes coding in a timely manner.
Provides assistance in chart completion activities to the Medical and Hospital staff to support timely billing and reimbursement.
Initiates provider queries via written or verbal query as necessary, to assure compliant, comprehensive documentation to substantiate optimal assignment of codes for reimbursement and in support of the clinical documentation improvement and quality initiatives of CGHMC.
Supports clinical documentation improvement initiatives through discussion of coding rules, verification of MS-DRG and APR-DRG, attendance at scheduled meetings, participation in training and education as requested by Coding Manager or Revenue Cycle Director.
Participates in education and training as directed by Coding Manager.
Maintain coding credential through education provided by CGHMC.
Work collaboratively with the Clinical Documentation Improvement team.