Coder III

CommonSpirit Health; United States; Remoto; USD 65.000 - 90.000; Tempo pieno

Descrizione del lavoro

CommonSpirit Health is seeking an experienced Coder III to code and abstract complex inpatient records, ensuring data integrity and accurate reimbursements. You will mentor staff, support audits, and assist with DRG denials and billing inquiries.

You will collaborate with Coding School Trainers and management to provide ongoing education and process improvements across the Coding Service Center.

Competenze

• Two to four years inpatient coding experience in an acute care setting.
• Current AHIMA credentials (RHIA/RHIT/CCS/CCS-P) or AAPC credentials (COC/CIC/CPC-H/CPC) or must obtain within 6 months of hire.
• Competency in inpatient coding guidelines and related guidelines.
• Proficient with Microsoft Windows applications (Word, Excel, PowerPoint, Outlook).
• Advanced knowledge of Coding Clinic Guidelines and ICD-10/ICD-PCS; disease management knowledge.

Mansioni

• Code and abstract inpatient records and assign DRGs per official guidelines and policies.
• Review coding for revenue cycle, perform audits, and draft DRG-related appeals when needed.
• Serve as liaison between inpatient coding, CDIS, and Revenue Management to identify trends and resolve issues.
• Answer complex coding questions and troubleshoot system or billing edits per regs.
• Facilitate training sessions and conduct quality audits to improve reimbursement.
• Assist management with personnel tasks and promote a professional team environment.

Conoscenze

Inpatient coding

DRG assignments

Coding guidelines

ICD-10/ICD-PCS

3M knowledge

Audits and denials

Mentorship

Formazione

High School Diploma/G.E.D.

Strumenti

Microsoft Windows

Descrizione del lavoro

Where You'll Work

With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Job Summary and Responsibilities

As our Coder III, you will serve in an expert-level capacity, responsible for coding and abstracting complex inpatient records to support accurate data retrieval, reimbursement, research, and analysis. You will play a pivotal role in maintaining high standards of clinical documentation and data integrity across the organization.

Every day, you will act as a primary resource for hospital staff and fellow coding team members by resolving billing-related inquiries and addressing coding follow-ups. Additionally, you will support leadership with critical administrative tasks, including managing DRG denials, navigating claim edits, conducting internal audits, and overseeing CHA data submissions.

To be successful in this role, you will leverage your deep technical expertise to provide mentorship and hands-on guidance to others. This includes working closely with Coding School Trainers to facilitate high-level inpatient training and collaborating with management to provide ongoing coding education and process improvements.

• Accurately code and abstract inpatient records and assign DRGs in compliance with official coding guidelines, regulatory standards, and organizational policies.
• Support the revenue cycle by performing detailed coding reviews, conducting audits, and drafting appeal letters to resolve DRG denials and billing disputes.
• Act as a key liaison between the inpatient coding team, CDIS, and Revenue Management departments to identify trends, resolve issues, and ensure consistent communication.
• Serve as a subject matter expert to answer complex coding questions and troubleshoot system or billing-related edits in accordance with regulatory requirements.
• Facilitate training sessions and conduct quality audits to promote accurate reimbursement practices, providing constructive feedback to improve team performance.
• Assist management with personnel-related tasks and foster a professional, team-oriented environment that aligns with the values and goals of the Coding Service Center.

Along with CO, KS and NM, this position is open to remote/out of state candidates residing in only these states:

• Alabama- Arizona- Arkansas- Colorado
• Florida- Georgia- Idaho- Indiana
• Iowa- Kansas - Kentucky- Louisiana
• Missouri- Mississippi- Nebraska- New Mexico
• North Carolina- Ohio- Oklahoma- South Carolina
• South Dakota- Tennessee- Texas- Utah
• Virginia- West Virginia- Wyoming

Job Requirements

Required

• High School Diploma/G.E.D. Required
• A minimum of two (2) - four (4) years of inpatient coding experience in an acute care setting
• Current AHIMA credentials (i.e. RHIA, RHIT, CCS, CCS-P) or AAPC credentials (COC, CIC, CPC-H, CPC) required and maintained OR must acquire certification within 6 months of hire
• Must demonstrate competency of inpatient coding guidelines as well as other inpatient coding guidelines
• Proficient in Microsoft Windows applications (i.e. Word, Excel, PowerPoint, Outlook)
• Demonstrate advanced knowledge of Coding Clinic Guidelines, and advanced technical knowledge with coding competency in ICD-10, ICD PCS and Nosology Advance knowledge of disease management, anatomy and physiology, medical terminology, pharmacology and coding systems (i.e. 3M)