Hospital Reimbursement & Coding Specialist III, Remote

Erlanger; Chattanooga (TN); Remote; USD 55,000 - 75,000; Full time

Job summary

Erlanger is seeking a Hospital Reimbursement & Coding Specialist III to work remotely, focusing on coding inpatient and outpatient cases. The role requires strong knowledge of coding guidelines and requires a coding certification. This is a full-time position offering opportunities for professional growth in a supportive environment.

Qualifications

• At least 4 years of coding experience in acute care hospital required.
• Licenses such as RHIT, RHIA, CCS, CPC, or CPC-H necessary.

Responsibilities

• Assign and sequence diagnosis and procedure codes for inpatient and outpatient encounters.
• Review medical records for accurate code assignment.

Skills

Knowledge of Anatomy and Physiology

Knowledge of Disease Pathology

Knowledge of Medical Terminology

Knowledge of coding conventions

Proficiency in navigating Electronic Medical Records

Education

Validation of coding certification from an accredited program

BS or AS degree in Health Information Management

Job description

Hospital Reimbursement & Coding Specialist III, Remote

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Hospital Reimbursement & Coding Specialist III, Remote

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Erlanger Health hires employees for telecommuting/remote positions in the following states:
AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, SC, TN, TX, VA, WI, WY

REMOTE

Job Summary:

Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators (inpatient only) on inpatient or outpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures.

Inpatient Coding

• Must code all types of adult and pediatric inpatient cases including long length of stays, mortality, trauma, L&D, NICU, and normal newborns.

Outpatient Coding

• Must code all types of outpatient cases including ED, outpatient, OBS, Same Day Surgery.

Detailed Responsibilities:

• Review inpatient or outpatient medical records to assign and sequence all appropriate diagnosis and procedures codes utilizing encoder software, following guidelines, and translating diagnostic statements, procedure descriptions, physician orders, and other documentation. Review Medicare Severity Diagnosis Related Groups (MSDRGs), All Patient Refined Diagnosis Related Groups (APRDRGs), or Ambulatory Payment Classification (APCs) for accurate code assignment.
• Validate accuracy of Admission-Discharge-Transfer (ADT) data fields; abstract admission type, point of origin, discharge disposition, physicians, procedure dates, and POA indicators on inpatient cases.
• Address coding edits and corrections in work queues; notify billing as needed; perform corrections for audits and external denials.
• Work with leadership to obtain additional documentation or physician clarification when documentation is incomplete, vague, or ambiguous.
• Follow charge verification processes and route accounts based on missing or inaccurate charges for outpatient coders.

Other Responsibilities Include:

• Adhere to HIM coding policies.
• Apply American Hospital Association (AHA) Official Coding Guidelines for diagnoses and procedures.
• Follow third-party documentation guidelines to improve coding quality and accuracy.
• Maintain coding certification and stay updated on coding guidelines and regulations.
• Contact physicians or departments for clarification on diagnoses and procedures.
• Participate in performance improvement initiatives.

This position must meet productivity and quality standards as defined by department leadership.

The Coder Must Have:

• Knowledge of Anatomy and Physiology, Disease Pathology, and Medical Terminology.
• Knowledge of coding conventions and CMS Official Guidelines for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding.
• Ability to accurately translate diagnostic and procedural descriptions into appropriate codes for reimbursement.
• Proficiency in navigating Electronic Medical Records.
• Knowledge of clinical content standards.

Education:

Required: Validation of coding certification from an accredited program (e.g., ICD-10-CM, ICD-10-PCS, CPT).

Preferred: BS or AS degree in Health Information Management or related field.

Experience:

Required: At least 4 years of coding experience in an acute care hospital supporting this role.

Preferred: Experience in a Level 1 academic medical center.

Position Requirements:

Required: Licenses/certifications such as RHIT, RHIA, CCS, CPC, or CPC-H.

Department Summary:

Must demonstrate knowledge and skills to code inpatient or outpatient encounters, understand various payment schemes, and work effectively in a remote team environment. Maintain certification and complete required continuing education annually or biannually. Perform additional tasks as assigned.

Location: Erlanger Baroness Hospital, Chattanooga, TN

Standard Hours:

Regular

Seniority Level:

• Mid-Senior level

Employment Type:

• Full-time

Job Function:

• Health Care Provider

Industries:

• Hospitals and Health Care