Inpatient Coder

DaMar Staffing; Village of Garden City (NY); On-site; USD 70,000 - 95,000; Full time

Job summary

DaMar Staffing is seeking an experienced Inpatient Coder to ensure accurate ICD-10-CM/PCS coding and abstracting of diagnoses and procedures in inpatient records, adhering to UHDDS definitions and DRG-based reimbursement.

The role requires attention to detail, strong analytical and communication skills, and collaboration with HIM/CDIS for complete documentation. A pre-employment coding proficiency assessment will be administered.

Qualifications

• 5+ years with ICD-10-CM/PCS, MS-DRG and APR-DRG models.
• AHIMA credential (RHIA/RHIT/CCS) preferred.
• Associate degree in Health Information Management preferred.
• Experience in a large hospital system (500+ beds) with multiple service lines.
• Experience with Epic and 3M-360 software a plus.
• Meet productivity and accuracy requirements.
• Pre-employment coding proficiency assessment will be administered.

Responsibilities

• Adherence to ICD-9, ICD-10-CM/PCS guidelines for coding.
• Assign principal/secondary diagnoses and procedures using MS-DRG/APR-DRG models.
• Assign POA indicators for inpatient diagnoses.
• Identify hospital-acquired conditions (HACs) from documentation and report to quality committees.
• Verify data and discharge disposition for coding compliance.
• Formulate queries for documentation clarification.
• Extract data from source docs into encoder/abstracting system.
• Review daily pre-bill edits and coding errors.
• Collaborate with HIM staff and CDIS for accurate documentation.
• Utilize coding software and HIMS for timely billing.
• Attend CEUs and coding compliance training.

Skills

ICD-10-CM/PCS

MS-DRG/APR-DRG models

Attention to detail

Effective communication

Education

AHIMA credential (RHIA/RHIT/CCS)

Associate degree in Health Information Management

Tools

Epic EMR

3M-360 software

DNFB tools

Job description

Job Description

The Inpatient Coder will be responsible for accurately coding and abstracting diagnoses, procedures and clinical information from the medical record. The individual will adhere to established coding guidelines for data quality and integrity, as well as productivity.

The Inpatient Coder plays an integral role in ensuring accurate and compliant coding of inpatient

records. This position requires an individual with attention to detail, strong analytical skills,

effective communication and collaboration skills. Duties and responsibilities include but are not

limited to:

• Adherence to ICD-9, ICD-10-CM/PCS Official Guidelines for Coding and Reporting, AHA Coding Clinic, CMS and other regulatory guidelines
• Applying the Uniform Hospital Discharge Data Set (UHDDS) definitions including regulatory guidelines to select the principal diagnosis, secondary diagnoses, & procedures utilizing MS-DRG, APR-DRG reimbursement expertise to assign appropriate ICD-10 CM and/or ICD-10-PCS diagnoses and procedures.
• Responsible for accurately assigning present on admission (POA) indicators for inpatient diagnoses.
• Accurately identifying hospital-acquired conditions (HACs) supported in physician documentation and reportable to corresponding quality committees.
• Verifying data and discharge disposition to assure coding compliance.
• Formulate appropriate queries in accordance with Guidelines for Achieving a Compliant Query Practice (2019 Update) for clarification of conflicting/ambiguous documentation, treatments or diagnostic tests given to patients for accurate code assignment and sequencing.
• Extracting required information from source documentation and enter into encoder and abstracting system.
• Reviewing daily pre-bill edits and coding errors to make corrections or complete missing data elements.
• Ability to collaborate with HIM Staff and Clinical Documentation Improvement Specialists (CDIS) to ensure the most accurate and complete documentation to support accurate coding/billing.
• Efficiently utilize Coding software and HIMS to abstract required data from patient visits in the appropriate coding assignments and timely billing in accordance with DNFB goals and established hospital policy and procedures.
• Attending continuing education workshops, webinars, etc., for coding compliance and maintenance of CEUs.
• A pre-employment coding proficiency assessment will be administered

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to [e-mail] learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

Skills and Requirements

• At least 5 years’ working experience with ICD-10-CM/PCS code sets and MS-DRG and APR-DRG payment models
• Successful completion of at least one AHIMA (American Health Information Management Association) certified program with achievement of the correlating professional credential preferred (RHIA, RHIT, and / or CCS, etc.)
• Associates or higher-level degree in a Health Information Management discipline preferred
• Prior experience working within a large hospital system (500 + beds), demonstrating familiarity with multiple service lines, facility coding guidelines, EMR platforms such as Epic and 3M-360 software a plus
• Candidates must have experience coding acute care Trauma/Teaching Level 1 Facility, Transplants – Kidney, Liver and Pancreas, Surgical Services including Gen Med Surg, Ortho, Cardiothoracic, Vascular, Bariatric, Gynecologic, Neurologic, Urologic, Colorectal, Behavioral Health, Gastroenterology, and Wound Care
• Meet coding productivity and accuracy requirements
• A pre-employment coding proficiency assessment will be administered