Senior Inpatient Coder

Essentia Health•Duluth, MN

1d•Remote

About The Position

This position is responsible for reviewing clinical documentation and assigning ICD-10-CM diagnosis, PCS procedure codes, and the DRG to ensure proper reimbursement for complex inpatient accounts. Requires extensive knowledge and understanding of ICD-10-CM/PCS coding guidelines, MS-DRG and APR-DRG reimbursement systems, medical terminology, and disease processes. Works closely with Clinical Documentation Integrity and clinicians to ensure complete and accurate documentation, coding, and final DRG assignment. Adheres to the quality and productivity standards set by the department.

Requirements

Successful completion of a coding program, which included coursework in ICD-10-CM/PCS, medical terminology, anatomy and physiology and disease processes
Two (2) years of hospital inpatient/DRG coding experience
Passing score on the Essentia Health senior inpatient coding skills assessment
Current certification with American Health Information Management Association (AHIMA) or AAPC and credentialed as Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), and/or Certified Inpatient Coder (CIC)

Nice To Haves

Epic experience
3M Encoder experience
Computer Assisted Coding experience

Responsibilities

Evaluates health record documentation and accurate reimbursement by ensuring that ICD-10-CM diagnostic and PCS procedural codes accurately reflect and support the inpatient hospital admission
Identifies documentation clarification opportunities to ensure that documentation supports the coding and DRG assignment.
Initiates coding queries and provides feedback to clinicians
Reviews Local Coverage Determination (LCD)/National Coverage Determination (NCD) policies for ICD-10-CM diagnoses that support medical necessity for services provided
Works with the coding denials team for education and assists with DRG denial prevention solutions
Ensures inpatient accounts are coded accurately and in a timely manner
Consistently maintains coding quality (95% accuracy) and productivity expectations
Assists with the training of inpatient coders
Performs related duties as required