Inpatient Medical Coding Specialist - Per Diem

KEY RESPONSIBILITES:

Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments.

• Assigns appropriate code(s) by utilizing coding guidelines established by:
  • The Centers for Disease Control (CDC), ICD-CM Official Coding Guidelines for Coding and Reporting, Centers for Medicare/Medicaid Services (CMS) ICD-PCS Official Guidelines for Coding and Reporting
  • American Hospital Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification
  • American Health Information Management Association (AHIMA) Standards of Ethical 
  • Coding
  • Revenue Excellence/HM coding procedures and guidelines 
• Knows, understands, incorporates, and demonstrates Huron’s Vision, and Values in behaviors, practices, and decisions.  

• Navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APR DRGs, and identify HACs and PSIs or other indicators that could impact quality data and hospital reimbursement.

• Codes Inpatient health records utilizing encoder software and consistently uses online tools to support the coding process and references to assign ICD codes, MS-DRG, APR DRGs, POA, SOI & ROM indicators.
• Reviews Inpatient health record documentation, as part of the coding process, to assess the presence of clinical evidence/indicators to support diagnosis code and MS-DRG, APR DRG assignments to potentially decrease denials.
• May work Inpatient claim edits and may code consecutive/combined accounts to comply with the 72-hour rule and other account combine scenarios.
• Adheres to the Inpatient coding quality and productivity standards established by the organization.
• Demonstrates knowledge of current, compliant coder query practices when consulting with physicians, Clinical Documentation Specialists (CDS) or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous documentation.
• Utilizes EMR communication tools to track missing documentation or Inpatient queries that require follow-up to facilitate coding in a timely fashion.
• Works with HIM and Patient Financial Services (PFS) teams, when needed, to help resolve billing, claims, denial and appeals issues affecting reimbursement.
• Maintains CEUs as appropriate for coding credentials as required by credentialing associations.
• Maintains current knowledge of changes in Inpatient coding and reimbursement guidelines and regulations as well as new applications or settings for Inpatient coding e.g., Hospital at Home.
• Identifies, and attempts to problem solve, coding and/or EMR workflow issues that can impact coding.
• Exhibits awareness of health record documentation or other coding ethics concerns. Notifies appropriate leadership for assistance, resolution when appropriate.
• Maintains a working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
• My require abstracting of additional data elements. 
• Performs other duties as assigned by Leadership.

CORE QUALIFICATIONS:

• Current permanent U.S. Work Authorization required.

• Three (3) years of current acute care or Inpatient coding experience is required.
• Extensive, comprehensive working knowledge of medical terminology, Anatomy and Physiology, diagnostic and procedural coding and MS-DRG, APR DRG assignment.
• Must be proficient in identifying POA, SOI and ROM indicators for Inpatient records as well as HACs and PSIs to ensure accurate hospital reimbursement.
• Current experience utilizing encoding/grouping software and Computer Assisted Coding (CAC) is preferred. 
• Ability to use a standard desktop/laptop, email and other Windows applications, if needed, Internet and web-based training tools preferred. 
• Strong oral and written communication skills. Ability to communicate effectively with individuals and groups representing diverse perspectives.
• Ability to research, analyze and assimilate information from various sources based on technical and experience-based knowledge.
• Must exhibit critical thinking skills, strong problem- solving skills and the ability to prioritize workload.
• Excellent organizational and customer service skills. Ability to perform frequent detailed tasks and provide productivity standard driven results.
• Ability to adapt to change and be flexible with work priorities and interruptions. 
• Must be comfortable functioning in a virtual, collaborative, shared leadership environment with minimal supervision and able to exercise independent judgement. 
• Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Huron.

PHYSICAL DEMANDS:

• This role requires remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction though video/audio conference calls and possible use of a headset with microphone; very rarely duties might require the ability to lift up to 20 pounds and bending & standing for periods at a time.

TECHNICAL QUALIFICATIONS:

• Required Certifications:
  • Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Documentation Improvement Practitioner (CDIP)
• Registered Health Information Administrator (RHIA) preferred

• Encoder experience (3M/Solventum, Encoder Pro, Codify) preferred
• Epic experience preferred
• Cerner experience preferred
• Meditech experience preferred