Coder IV, Inpatient (Remote)

Lensa; Livonia (MI); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare provider is seeking a skilled coding professional to analyze inpatient health records and ensure accurate coding for reimbursement. The ideal candidate will have significant experience in coding, strong communication skills, and relevant certifications. Join a diverse and inclusive team committed to excellence in healthcare.

Qualifications

• Completion of AHIMA-approved coding program or equivalent experience.
• RHIT, RHIA, or CCS certification required.
• At least 3 years of inpatient coding experience.

Responsibilities

• Analyze physician/provider documentation for coding.
• Assign appropriate MS-DRG and APR DRG codes.
• Collaborate with teams to resolve billing and claims issues.

Skills

Medical terminology

Anatomy

Physiology

Coding

Communication

Education

AHIMA-approved coding program

Associate’s degree in Health Information Management

Bachelor’s degree (preferred)

Tools

Encoder software

CAC software

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
Day Shift

Description

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

Essential Functions

• Demonstrates understanding of Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
• Accurately navigates patient health records and computer systems to determine diagnosis and procedure codes, MS-DRGs, APR DRGs, HACs, and PSIs.
• Codes inpatient health records using encoder software and online tools, supporting the assignment of ICD codes, MS-DRG, APR DRG, POA, SOI & ROM.
• Reviews documentation to support diagnosis coding and MS-DRG, APR DRG assignments, reducing denials.
• Works with inpatient claim edits, coding consecutive/combined accounts per the 72-hour rule and other scenarios.
• Adheres to coding quality and productivity standards.
• Uses compliant query practices when consulting with healthcare providers for clarification or additional information.
• Utilizes EMR communication tools for tracking documentation and queries.
• Collaborates with HIM and PBS teams to resolve billing, claims, denial, and appeal issues.
• Maintains CEUs for coding credentials as required.
• Stays current with coding and reimbursement guidelines and regulations.
• Identifies and troubleshoots workflow or documentation issues impacting coding.
• Maintains awareness of coding ethics and reports concerns appropriately.
• Performs other duties as assigned and adheres to applicable laws, regulations, and policies.

Minimum Qualifications

• Completion of an AHIMA-approved coding program, Associate’s degree in Health Information Management or related field, or equivalent experience. Bachelor’s preferred.
• RHIT, RHIA, or CCS certification required.
• At least 3 years of current inpatient coding experience with proficiency in medical terminology, anatomy, physiology, and coding, including POA, SOI, and ROM indicators.
• Experience with encoding software and CAC preferred.
• Strong communication skills and ability to research and analyze information effectively.

Hourly Pay Range: $27.41 - $41.13

Our Commitment to Diversity and Inclusion

Trinity Health is a large, nonprofit, Catholic healthcare system committed to diversity, equity, and inclusion. We serve diverse populations and foster an inclusive environment for our colleagues, promoting respectful, culturally competent care. We are an Equal Opportunity Employer, considering all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected statuses.