Inpatient Coder Specialist - Hospital Based Service Line Job at Advocate Health Care

Job Description

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.

Job Responsibility

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

Requirements

Coding Certification issued by American Academy of Coders (AAPC) or American Health Information Management Association (AHIMA)
Associate's Degree in Health Information Management or related field
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
Advanced profiency of ICD, CPT and HCPCS coding guidelines
Advanced knowledge of medical terminology, anatomy and physiology
Excellent computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications
Excellent communication (oral and written) and interpersonal skills
Excellent organization, prioritization, and reading comprehension skills
Excellent analytical skills, with a high attention to detail
Ability to work independently and exercise independent judgment and decision making
Ability to meet deadlines while working in a fast-paced environment
Ability to take initiative and work collaboratively with others

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance
Premium pay such as shift, on call, and more
Incentive pay for select positions

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Inpatient Coder Specialist - Hospital Based Service Line

Job Description

Job Responsibility

Requirements

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