Coding Specialist II Inpatient - MS-DRG (CCS Required)

MedStar Health; United States; On-site; USD 39,619 - 67,447; Full time

Job summary

MedStar Health is seeking an Inpatient Coding Specialist II to analyze and interpret clinical documentation for coding inpatient facility records. The role requires adherence to quality and safety standards while maintaining compliance with regulations. Candidates must have 3-4 years of inpatient coding experience and CCS certification. The position offers a pay range of USD $28.76 - $48.96 per hour, emphasizing analytical skills and effective communication.

Qualifications

• 3-4 years inpatient coding experience required.
• Experience with clinical information systems required.
• CCS (Certified Coding Specialist) required.

Responsibilities

• Analyze and interpret clinical documentation for coding.
• Contributes to department goals and adheres to quality standards.
• Assign correct diagnostic and procedural codes.

Skills

Verbal and written communication skills

Basic computer skills

Strong analytical and organizational skills

Education

High School Diploma or GED

Associate's degree in coding-related degree

Bachelor's degree in coding-related degree

Courses in Medical Terminology, Anatomy & Physiology, ICD-CM and ICD-PCS

Tools

Solventum grouper

Electronic medical records

Computer-aided coding

Job description

General Summary of Position

The Inpatient Coding Specialist II analyzes and interprets clinical documentation to accurately code and abstract inpatient facility records for all MedStar entities in accordance with established ICD-10-CM/PCS coding classification systems.

Primary Duties And Responsibilities

• Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.
• Abstracts and ensures accuracy of diagnoses, procedure, patient demographics and other required data elements.
• Adheres to all compliance regulations and maintains annual compliance education.
• Maintains continuing education and seeks ongoing education to improve job performance. Maintains credentials as required for job classification.
• Contacts physician when conflicting or ambiguous information appears in the medical record. Adheres to the MedStar Coding Query Policy and procedure.
• Consistently meets or exceeds established quality standards as defined by policies.
• Consistently meets or exceeds established productivity standards as defined by policies.
• Resolves all quality reviews timely (Medical necessity reviews; coding quality assurance reviews; external vendor reviews).
• Reviews medical record documentation to identify diagnoses and procedures. Assigns correct diagnostic and procedural codes using standard guidelines and automated encoding software, maintaining departmental accuracy standards. Determines the sequence of diagnoses according to Uniform Hospital Discharge Data Definitions and assigns appropriate DRG (Diagnosis Related Groups).
• Exhibits knowledge of the Solventum system and other work-related equipment.
• Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
• Participates in multidisciplinary quality and service improvement teams.
• Performs other duties as assigned.

Education

• High School Diploma or GED required
• Associate's degree in coding-related degree preferred
• Bachelor's degree in coding-related degree preferred
• Courses in Medical Terminology, Anatomy & Physiology, ICD-CM and ICD-PCS required

Experience

• 3-4 years inpatient coding experience required
• Experience with clinical information systems (Solventum grouper, electronic medical records, computer-aided coding) required

Licenses and Certifications

• CCS (Certified Coding Specialist) required
• RHIT (Registered Health Information Technician) preferred
• RHIA (Registered Health Information Administrator) preferred

Knowledge Skills And Abilities

• Verbal and written communication skills.
• Basic computer skills required.
• Strong analytical and organizational skills; ability to prioritize workloads and meet deadlines.

This position has a hiring range of USD $28.76 - $48.96 per hour.