Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account.

Exemption Status:

Non-Exempt

Schedule Details:

Monday through Friday

Scheduled Hours:

40 hrs

Shift:

1 - Day Shift, 8 Hours (United States of America)

Hours:

40

Cost Center:

99940 - 5458 Coding Services

Union:

SHARE (State Healthcare and Research Employees)

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 16,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

The Inpatient Coder II is an advanced coding position responsible for accurate and timely assignment of codes to diagnoses and procedures for all inpatient cases. Interprets a wide variety of clinical and diagnostic documentation, including complex medical cases and treatments, to identify: diagnoses, complications, comorbidities, and procedures associated with episodes of inpatient care. Assigns appropriate Diagnosis Related Group (DRG) to each coded inpatient account to obtain optimal hospital reimbursement, Severity of Illness (SOI), and Risk of Mortality (ROM). Assigns current edition of ICD-CM, ICD-PCS, and CPT codes as appropriate adhering to official coding guidelines. Communicates directly with clinicians through the electronic medical record (EMR) query process. Assists in training of new personnel.

Major Responsibilities:

• Upon review of the medical record, performs analysis on documentation, which includes: History & Physical (H&P), progress notes, flow sheets, Provider orders, consultations, operative reports, pathology results, and additional tests / reports to determine the appropriate current edition ICD-CM diagnosis and ICD-PCS codes as defined by official coding guidelines, the Coding Clinic, and other recognized reference materials.
• Required to accurately assign and / or correct the discharge disposition status based on clinical documentation to ensure proper reimbursement.
• Assigns the correct principal diagnosis, comorbidities and complications (CCs), secondary diagnoses, POA (Present on Admission) indicators, HAC (Hospital-Acquired Conditions), principal procedure codes, and secondary procedure codes according to official coding guidelines, the Coding Clinic, and in accordance with all official Uniform Hospital Discharge Data Set (UHDDS) definitions.
• Based upon the assigned codes, utilizes the computerized 3M Encoder software to assign the most accurate DRG.
• Performs and facilitates retrospective queries when documentation is inconsistent, incomplete, ambiguous, or non-specific.

Position Qualifications:

License/Certification/Education:

Required:

• Level of knowledge equivalent to an Associate or bachelor’s degree in Health Information Management.
• Certification(s) as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P), or Certified Inpatient Coder (CIC) required upon hire.

Experience/Skills:

Required:

• Proficient in utilizing multiple payer-specific DRG groupers as required by individual payers.
• Thorough knowledge of the current editions of DRG, ICD-CM, ICD-PCS, and CPT coding systems.
• Thorough knowledge of third-party payer requirements as well as federal and state guidelines and regulations pertaining to coding and billing practices.
• Excellent customer service skills with the ability to communicate efficiently.
• Exceptional organizational skills with attention to detail.
• Ability to work independently within established guidelines.
• Excellent oral and written communication skills.
• Ability to organize and coordinate multiple functions and tasks.
• Ability to problem solve, organize and prioritiz