Coder IV Inpatient, Remote

Lensa; Livonia (MI); Remote; Full time

Job summary

A leading healthcare organization is seeking a coding professional to analyze inpatient health records, ensuring accurate coding and compliance with regulations. The role demands expertise in medical terminology and coding standards, along with strong communication skills. Join a diverse team committed to equitable care and innovation in health outcomes.

Qualifications

• Completion of an AHIMA-approved coding program required.
• At least 3 years of inpatient coding experience.

Responsibilities

• Codes inpatient health records using encoder software.
• Reviews documentation to verify clinical evidence supporting diagnoses.

Skills

Communication

Research

Analysis

Education

Associate’s degree in Health Information Management

Bachelor’s degree preferred

Tools

Encoder software

Windows applications

Job description

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Trinity Health, is seeking professionals. Apply via Lensa today!

Employment Type
Full time

Shift

Description:

Provides high-level technical competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement. Utilizes encoder software applications, including all applicable online tools and references, to assign ICD-CM diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM.

Essential Functions

1. Demonstrates understanding and incorporation of Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
2. Accurately navigates patient health records and computer systems to determine diagnosis and procedure codes, MS-DRGs, APR DRGs, and identifies HACs and PSIs impacting data and reimbursement.
3. Codes inpatient health records using encoder software and online tools to support accurate ICD coding, MS-DRG, APR DRG, POA, SOI & ROM assignments.
4. Reviews inpatient documentation to verify clinical evidence supporting diagnoses and MS-DRG, APR DRG assignments to reduce denials.
5. Works with inpatient claim edits, codes consecutive/combined accounts per the 72-hour rule and other scenarios.
6. Adheres to coding quality and productivity standards as established.
7. Uses compliant query practices when consulting with healthcare providers for clarification or additional information.
8. Utilizes EMR tools for tracking documentation and follow-up queries.
9. Collaborates with HIM and Patient Business Services teams to resolve billing, claims, and denial issues.
10. Maintains CEUs for coding credentials as required.
11. Stays current with changes in coding, reimbursement guidelines, and new applications like Hospital at Home.
12. Identifies and troubleshoots workflow issues affecting coding processes.
13. Maintains awareness of documentation and coding ethics, reporting concerns appropriately.
14. Performs additional duties as assigned by leadership.
15. Ensures compliance with applicable laws, regulations, and policies, demonstrating ethical and professional behavior.

Minimum Qualifications

• Completion of an AHIMA-approved coding program, associate’s degree in Health Information Management or related field, or equivalent education and experience. Bachelor’s preferred.
• RHIT, RHIA, or CCS certification required.
• At least 3 years of inpatient coding experience, with strong knowledge of medical terminology, anatomy, physiology, coding, and MS-DRG/APR DRG assignment. Proficiency in identifying POA, SOI, ROM, HACs, and PSIs.
• Experience with encoding/grouping software and CAC preferred.
• Proficient in Windows applications, email, internet, and web-based training tools.
• Strong communication skills for effective interaction with diverse groups.
• Ability to research and analyze information from various sources.

Hourly Pay Range: $27.41 - $41.13

Our Commitment to Diversity and Inclusion

Trinity Health emphasizes diversity, equity, and inclusion, reflecting its mission and core values. The organization values diverse experiences, customs, and talents, fostering an inclusive environment to provide equitable care. Trinity Health is an Equal Opportunity Employer, committed to nondiscrimination regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected statuses.

Serving across 25 states with a large workforce, Trinity Health recognizes the importance of understanding cultural differences to improve health outcomes and foster innovation. Their diversity initiatives include training, recruitment, retention, community partnerships, and supplier diversity.