Facility Coding Inpatient DRG Quality Coder

Department Name:

Work Shift:

Day

Job Category:

Revenue Cycle

Estimated Pay Range:

$27.72 - $46.20 / hour, based on location, education, & experience.

In accordance with State Pay Transparency Rules.

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In this Inpatient Facility/HIMS Certified Medical Coder, Quality Associate position, you bring your 5 years of acute care inpatient coding background to a team that values growth and development!

This is a Quality position, not a day-to-day coding production role but does require coding proficiency and recent Hospital Facility Coding experience. This position is task-production-oriented ensuring quality in the Inpatient Facility Coding department. If you have experience with DRG and PCS coding/denials/audits, we want to hear from you.

Requirements:

• 5 years recent experience in acute-care Inpatient facility-based medical coding;
• DRG and PCS experience
• Bachelors degree in HIMS or equivalent;
• Certified Coders, as defined in minimum qualifications below

In most of our Coding roles, there is a Coding Assessment given after each successful interview. Banner Health provides your equipment when hired. You will be fully supported in training for anywhere from 1 – 3 months according to individual needs, with continued support throughout your career here!

This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY.

** Don't quite meet the above requirements? Check out some of our other Coder positions!

POSITION SUMMARY

This position is responsible for the interpretation of clinical documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. Works with clinical documentation improvement and quality management staff to:  align diagnosis coding to documentation to improve the quality of clinical documentation and correctness of billing codes prior to claim submission; to identify possible opportunities for improvement of clinical documentation and accurate MS-DRG, Ambulatory Payment Classification (APC) or ICD-10 assignments on health records. Provides guidance and expertise in the interpretation of, and adherence to, the rules and regulations for code assignment based on documentation for all levels of complexity to include accounts encountered in Banner’s Academic, Trauma, high acuity and critical access facilities, as well as specialized services such as behavioral health, oncology, pediatric. Acts as subject matter expert regarding experimental and newly developed procedure and diagnostic coding.

CORE FUNCTIONS

1. Provides guidance on coding and billing, utilizing coding and billing guidelines. Demonstrates extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG)  and Ambulatory Payment Classification (APC) or utilized operational systems. Provides explanatory and reference information to internal and external customers regarding coding assignment based on clinical documentation which may require researching authoritative reference information from a variety of sources.

2. Reviews medical records. Performs an audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete. Provides feedback on coding work and trends, and offers suggestions for improvement where opportunities are identified. Reviews accuracy of identified data elements for use in creating data bases or reporting to the state health department. If applicable, applies Uniform Hospital Discharge Data Set (UHDDS) definitions to select the principal diagnosis, principal procedure, complications and co morbid condition, other diagnoses, and significant procedures which require coding. Apply policies and procedures on health documentation and coding that are consistent with official coding guidelines.

3. Assists with maintaining system wide consistency