Inpatient Coder

Good Shepherd Rehabilitation; Allentown (Lehigh County); Remote; USD 50,000 - 70,000; Full time

Job summary

An established industry player in healthcare is seeking a detail-oriented Medical Coder to join their remote team. This role involves accurately coding patient records, ensuring compliance with coding guidelines, and collaborating with healthcare professionals to improve clinical documentation. The ideal candidate will have a strong background in ICD coding and a commitment to maintaining high accuracy standards. Join a supportive environment that values your contributions and offers opportunities for professional growth while making a difference in patient care.

Benefits

Medical insurance

Vision insurance

Tuition assistance

Disability insurance

Qualifications

• 2-4 years of inpatient coding experience with ICD-9-CM and/or ICD-10-CM/PCS.
• Knowledge of coding guidelines and medical record management.

Responsibilities

• Code all diagnoses, treatments, and procedures accurately.
• Resolve discrepancies in medical records and assist with documentation improvements.

Skills

ICD-10 Coding

Medical Record Review

Clinical Documentation Improvement

Data Entry

Education

High School Diploma

AHIMA Independent Study Program

Job description

*This position is remote, and the candidate must reside in Pennsylvania or New Jersey*

JOB SUMMARY

• Reviews patient records, assigns diagnostic and procedural codes, performs related functions and participates in Performance Improvement activities.

ESSENTIAL FUNCTIONS

DIAGNOSTIC CODING OF ALL MEDICAL RECORDS REPORTED ON PATIENT BILLS

• By coding all diagnoses, treatments, and procedures according to the appropriate classification system for the category of patient encounter
• By accurately coding all inpatient records in accordance with ICD-10 CM/PCS coding rules and guidelines in a timely manner with a 95% accuracy rate
• By following approved coding conventions, assigns diagnostic and procedural codes to inpatient records
• Reviews AHA Coding Clinic and demonstrates the ability to accurately apply new coding guidelines.
• Researches new diagnostic and procedure codes as required performing the coding function.
• Informs coding supervisor of trends and opportunities for improvement in clinical documentation.
• Works collaboratively with other coders.
• Adheres to the American Health Information Management’s Code of Ethics.

LOCATES MEDICAL RECORDS THAT REQUIRE CODE ASSIGNMENT

• By searching master patient index; identifying location of existing patient records and obtaining the documentation required for code assignment.

MAINTAINS MEDICAL RECORDS OPERATIONS

• By following policies and procedures; reporting needed change

RESOLVES MEDICAL RECORD DISCREPANCIES

• By acting as a resource to other staff on coding issues
• By assisting the physicians with documentation improvement via the diagnostic query form
• By collecting and analyzing information

MAINTAINS HISTORICAL REFERENCE

• By abstraction and data entry of all inpatient records into the Good Shepherd Hospital computer system for clinical and financial purposes
• By abstracting and coding clinical data, such as diseases, procedures, using standard classification systems.
• By providing DRG/CMG forecasting information to Nurse Liaison as needed.
• By accurately assigning the correct principal diagnosis on LTCH and rehab accounts.
• By performing weekly/bi-weekly concurrent chart reviews for any potential DRG/CMG changes during the patient stay.
• By coding all discharged charts timely and accurately

PROVIDES MEDICAL RECORD INFORMATION

• By providing codes for billing and answers questions from hospital staff
• By assisting physicians and other direct patient care professionals in questions regarding level of detail for diagnostic entries, according to the organization’s guidelines
• By complying with legal requirements.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education

• High School Diploma required
• Completion of the AHIMA independent study program preferred

Work Experience

• 2-4 years of inpatient coding experience utilizing ICD-9-CM and/or ICD-10-CM/PCS required

Licenses / Certifications

• RHIA, RHIT, CCS, CPC, active member in AHIMA preferred

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

Medical insurance

Vision insurance

Tuition assistance

Disability insurance

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