Inpatient Hospital Coder

The Nemours Foundation•Orlando, FL

3d•Onsite

About The Position

Nemours is seeking an Inpatient Hospital Coder in Orlando, FL. This role is responsible for assessing documentation content for services rendered in the hospital setting and/or professional setting to accurately code principal diagnoses, secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer-specific rules for commercial and/or Medicaid insurance, and drug administration for specified service lines. The coder will exhibit unique talent and comprehension to assign codes for multiple encounters/sessions (i.e., single path coding) from hospital to professional lines of business, processing services that exist on the same date of service, in the same place of service (POS). This includes services with the same documentation but different code assignments (i.e., radiology) with a focus on specific ordering practices.

Requirements

Medical Terminology, Anatomy and Physiology
One of the following: CCS, RHIT, RHIA
3-5 years experience

Nice To Haves

Associate's degree preferred
Preferred CRC

Responsibilities

Assess documentation content for services rendered in the hospital setting and/or professional setting to accurately code principal diagnoses, secondary conditions, procedures, and social determinant codes.
Assign codes for multiple encounters/sessions (i.e., single path coding) from hospital to professional lines of business.
Process services that exist on the same date of service, in the same place of service (POS), including services with the same documentation but different code assignments (i.e., radiology).
Comprehend medical record documentation to accurately assign codes for each active session, in multiple specialties.
Meet minimum requirements for production and quality monthly for all procedures/surgeries assigned a CPT code (hospital and professional).
Apply payer-specific rules for code sequencing, requiring attention to detail to avoid rework and waste.
Understand and apply M.E.A.T. criteria (monitoring, evaluation, assessment, treatment) using ICD 10 CM transaction data set to capture diagnoses.
Analyze high-risk encounters for accurate charge capture and charge gaps prior to encounter completion (i.e., missing charges from anesthesia, surgery) where manual charge capture occurs.
Incorporate payer-specific trends into day-to-day reviews to reduce take-backs associated with unclear or unsubstantiated care rendered.
Facilitate modifications to clinical documentation through concurrent interaction to ensure information captured supports the level of service rendered, with attention towards chronic conditions, hierarchical condition categories (HCC), and risk adjustment factors (RAF).
Code for hospital and professional sessions routinely as part of daily work.
Exhibit proficiency in all surgical coding for three or more surgery-based product lines: Cardiac, ENT, General Surgery/GI, Neurosurgery, Plastics, and Urology.
Utilize hospital information systems to retrieve specific data (i.e., order diagnosis, patient type) within a complicated filing schema, including non-hospital data (i.e., Media Tab, Office Visits etc.).