Senior Inpatient DRG Coder - Remote

LCMC Health•New Orleans, LA

10d•Remote

About The Position

The Coding Senior applies appropriate ICD-10-CM/PCS and CPT diagnostic and procedural codes and determines MS-DRG and APR-DRG assignments for inpatient records across multiple specialties. The role may also involve assigning ICD-10 diagnostic and CPT procedure codes for ambulatory records across multiple specialties. The Coding Senior may be assigned any of the coding functions of a Coding Specialist I. The position requires accurate coding and grouping, charge validation, communication with clinical and office staff about documentation needs, and timely follow-up on coding issues. The Coding Senior maintains knowledge of coding and reimbursement requirements, protects patient confidentiality, meets departmental quality and productivity standards, and follows applicable laws, regulations, ethical standards, and organizational policies.

Requirements

High school diploma/GED or equivalent and 3 years of work experience; or an associate degree and 1 year of experience; or a coding diploma/certification and 1 year of experience.
Comprehensive working knowledge of medical terminology, anatomy and physiology, diagnostic and procedural coding, MS-DRG or APC grouping, and charge description master components for charging functions.
Knowledge of third-party reimbursement regulations and billing practices.
Experience utilizing encoding/grouping software.
Ability to use standard desktop and Windows-based computer systems, including basic email, internet, and computer navigation.
High ethical standards.
Knowledge of ICD-10-CM, ICD-10-PCS, CPT/HCPCS, MS-DRG, APR-DRG, and APC coding principles and guidelines.
Experience in ICD-10-CM/PCS coding and reimbursement training.
Knowledge of Prospective Payment System methodology for inpatient, outpatient, ambulatory, and provider-based clinic encounters.
Knowledge of hospital and professional coding, including provider-based billing.
Knowledge of Joint Commission and CMS documentation regulations.
Experience with concurrent coding reviews.
Knowledge of privacy and security regulations, confidentiality, laws, and access and release of information practices.
Experience assisting with identifying learning needs and providing training to coding staff.
Strong analytical abilities and problem-solving skills.
Excellent oral, written, and interpersonal communication skills.
Ability to organize and set priorities to meet objectives in a timely manner.
Ability to adapt to change and handle challenges proactively.
Ability to collaborate effectively with physicians and managerial staff at all levels.

Nice To Haves

Associate degree in HIM or a similar field, completion of an AHIMA-approved coding program, or completion of an AAPC coding program.
Registered Health Information Technician (RHIT) certification from CCHIIM/AHIMA.
Registered Health Information Administrator (RHIA) certification from CCHIIM/AHIMA.
Certified Coding Specialist (CCS) certification from CCHIIM.

Responsibilities

Assign appropriate ICD-10-CM/PCS and CPT diagnostic and procedural codes and determine MS-DRG and APR-DRG assignments for inpatient records across multiple specialties.
Assign appropriate ICD-10 diagnostic and CPT procedure codes for ambulatory records across multiple specialties when assigned.
Navigate patient health records and other computer systems or sources to determine codes, MS-DRGs, APCs, and required modifiers accurately.
Validate charges by comparing them with health record documentation as necessary.
Communicate with clinical staff, physicians, office staff, and Clinical Documentation Improvement Specialists about documentation issues or needs for inpatient, outpatient, or ambulatory coding.
Identify concerns, notify appropriate leadership, and resolve moderate to complex problems.
Track missing documentation, charges, physician queries, and other issues requiring follow-up to support timely coding.
Meet or exceed coding quality and productivity standards established by the coding department.
Follow LCMC confidentiality requirements regarding release of individual or aggregate patient information.
Maintain current knowledge of coding and reimbursement guideline and regulatory changes.
Maintain working knowledge of applicable federal, state, and local coding and reimbursement laws and regulations, the Code of Ethics, and organizational policies and procedures.
Perform other duties as assigned by leadership.
May perform coding functions assigned to a Coding Specialist I.