Coder - Inpatient DRG Coding

Geisinger; Pennsylvania; Remote; USD 40,000 - 55,000; Full time

Job summary

A leading healthcare organization is seeking a Coder I to review and code medical records accurately. The role involves translating diagnostic phrases into codes, ensuring compliance with coding regulations, and assisting in training new staff. This position offers remote work options and requires a Medical Billing and Coding Diploma. Candidates with relevant experience and certifications may be considered for higher levels.

Qualifications

• 1 year of relevant experience or specialty training required.
• Minimum of one certification required for higher levels.

Responsibilities

• Review medical records to identify diagnoses and procedures.
• Translate diagnostic phrases into coded form using Encoder software.
• Assist in training new coding staff on guidelines and software.

Skills

PCS procedural coding

DRG coding

ICD10-PCS

Education

Medical Billing and Coding Diploma

Job description

Job Responsibilities:

1. Review the content of medical records for hospital and professional inpatient records to identify principal diagnoses, secondary diagnoses, and procedures performed that explain the reason for service or admission, patient severity, and compliance with standard provider coding regulations.
2. Carefully review documents such as laboratory findings, radiology reports, scan reports, discharge summaries, history and physicals, consultations, orders, progress notes, and other ancillary treatment records to ensure all pertinent diagnoses and procedures are recorded.
3. Translate all diagnostic and procedural phrases used by healthcare providers into coded form using procedure codes as required.
4. Use Encoder software to determine the codes for all diagnoses and procedures.
5. Sequence codes appropriately to maximize reimbursement legally.
6. Assign the appropriate DRG.
7. Code based on hospital and professional coding guidelines, Coding Clinic directives, federal regulations, CCI coding initiatives, CPT Assistant, or other standard guidelines.
8. Query physicians as needed to clarify documentation within the patient's record for complete and accurate coding.
9. Understand and apply internal policies regarding physician queries.
10. Assist the Coding Quality and Professional Manager with training new coding staff on hospital and professional coding guidelines, encoder, and software systems, and review coding guidelines annually with recommendations for improvements.
11. Report new diagnoses, procedures, technologies, etc., documented within patient records to ensure proper coding and guideline updates.
12. Update and correct historical file data by submitting claim action reports per quarterly PHC4 reports.

Work Environment and Additional Information:

Work is typically performed in an office environment. The employee is accountable for fulfilling all job-specific obligations and adhering to organizational policies and procedures.

#LI-REMOTE

*Relevant experience may include related work experience and/or completed specialty training (1 year of specialty training = 1 year relevant experience).

This opening is for a Coder I position. Geisinger may consider candidates for higher levels based on skills, qualifications, and experience. All qualified individuals are encouraged to apply.

Preferred qualifications:

• PCS procedural coding experience
• Familiarity with DRG coding, MDCs, and ICD10-PCS

For Coder I: Medical Billing and Coding Diploma required.

For Coder II and above: Minimum of one certification required:

• Certified Professional Coder - AAPC
• Certified Risk Adjustment Coder - AAPC
• Registered Health Information Technician - AHIMA

Internet Requirements:

Employee must have/supply:

• High-speed cable modem (no DSL, wireless cellular, or satellite)
• Minimum speeds: 25 MBPS upload, 75 MBPS download
• Ping < 150 ms, Jitter < 30 ms

Computer must connect via Ethernet; WiFi is only permitted with a VPN.