Hybrid Inpatient Coding Specialist – Remote/Onsite

Gaylord Specialty Healthcare; Wallingford (CT); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Gaylord Specialty Healthcare seeks an Inpatient Coding Specialist to join our HIM team. You will review inpatient records, assign ICD-10-CM diagnoses and ICD-10-PCS procedures per AHIMA standards and guidelines, and collaborate with clinicians to ensure accurate DRG assignments and compliant coding.

You will conduct physician queries, educate staff on documentation, and generate monthly reports to support revenue integrity and quality assurance.

Qualifications

• Associate's degree or equivalent in Health Information Management; Bachelor's preferred.
• Minimum 3 years of direct inpatient hospital coding experience.
• Credentialing: CCS, CCS-P, RHIT or RHIA through AHIMA or CPC preferred.
• Expertise with ICD-10-CM and ICD-10-PCS and Official Coding Guidelines.
• Keep up with official coding guidelines and continuing education to maintain certification.
• Proficient with EMR systems and coding references/software.
• Extensive CMS Hospital PPS knowledge and DRG assignment.

Responsibilities

• Review inpatient records and assign principal and secondary diagnoses and procedures upon admission, during stay, and at discharge.
• Apply PPS knowledge to ensure accurate DRG assignment and reimbursement.
• Communicate DRG assignments and changes to clinical staff.
• Collaborate with Utilization Management to ensure timely code assignment.
• Form physician queries to obtain missing documentation and clarification.
• Assist with payer requests for case review or DRG validation.
• Provide education to physicians and staff on coding requirements.
• Generate monthly reports and track trends for quality improvement.
• Participate in internal and external coding audits.

Skills

ICD-10-CM / ICD-10-PCS coding

Analytical thinking

Education

Associate's degree or equivalent in Health Information Management, Bachelor’s preferred

Tools

Electronic medical records

Coding references & software

Job description

Gaylord Specialty Healthcare seeks an Inpatient Coding Specialist to join our HIM team. You will review inpatient records, assign ICD-10-CM diagnoses and ICD-10-PCS procedures per AHIMA standards and guidelines, and collaborate with clinicians to ensure accurate DRG assignments and compliant coding.

You will conduct physician queries, educate staff on documentation, and generate monthly reports to support revenue integrity and quality assurance.