Inpatient Coder Specialist - Hospital Based Service Line

Department:

10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

Desired Experience:

• Hospital Based Service Line for Cardiology, Neurology and Oncology (CNO)

Schedule:

• Monday - Friday Flexible 1st shift / 40 hours a week

Certification desired:

• AHIMA – CCS, AHIMA -RHIT or AHIMA – RHIA

Remote opportunity:

Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY

Pay Range

$28.55 - $42.85

Major Responsibilities:

• This role will have all responsibilities of coder I, II and III in addition to: reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software.

• Adhere to organizational and internal department policies and procedures to ensure efficient work processes.

• Responsible for coding high dollar and long length of stay cases for all patient types.

• Expertise in query guidelines, and coding standards. Follow up and obtain clarification of inaccurate documentation as appropriate.

• Serves as a subject matter expert to Coding department leaders and peers. Recommends modifications to current policies and procedures as needed to coincide with government regulations.

• Maintain continuing education by attending webinars, reviewing updated CPT assistant guidelines and updated coding clinics. Knowledgeable in researching coding related topics and issues.

• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement.

• Collaborates with the Clinical Documentation Improvement and Quality teams, to ensure a match in the DRG and reconciles each Medicare case with the working DRGs from a CDI perspective.

• Responsible for clinician communication related to disease processes on a clinical level to ensure accurate coding.

• Participates in payer audits and meetings by acting as a resource for coding-related audits, as requested.

• Attends meetings with clinical teams regarding updates in codes for complex specialties.

• Maintains the confidentiality of patient records. Reports any perceived non-compliant practices to the coding leader or compliance officer.

• Meets and exceeds departmental quality (95% or more) and productivity standards (100%). Achieves productivity expectations to support discharged not final billed (DNFB).

• Performs any other assigned duties since the duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time.

Licensure, Registration, and/or Certification Required:

• Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA)

Education Required:

• Associate's Degree in Health Information Management or related field.

Experience Required:

• Typically requires 7 years' experience inpatient coding in acute care tertiary facility that includes experience in revenue cycle processes, Clinical Documentation Improvement, Research and health information workflows.

Knowledge, Skills & Abilities Required:

• Advanced profiency of ICD, CPT and HCPCS coding guidelines. Advanced knowledge of medical terminology, anatomy and physiology.
• Excellent compu