Inpatient Coder 2 Certified / HIM Coding

AAPC; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

Hartford HealthCare is seeking a Coding Specialist to review inpatient clinical documentation and assign ICD-10-CM diagnoses and ICD-10-PCS procedure codes for complex accounts, using CAC/encoder and related reference materials.

You will collaborate with clinical documentation specialists and billing teams to ensure accurate DRG assignments, adherence to coding guidelines, and achievement of KPI targets within the revenue cycle.

Qualifications

• AA/AS degree or equivalent experience is required.
• Two to three years of progressive on-the-job experience in an acute care hospital.
• Certified Coding Specialist (CCS) certification is required and maintained thereafter.

Responsibilities

• Applies knowledge of anatomy, physiology, disease processes and coding terminology to assign diagnoses and procedures for complex accounts.
• Analyses medical records using UHDDS to assign ICD-10-CM diagnoses and ICD-10-PCS codes with CAC/encoder and reference materials.
• Reviews DRG assignments, enters coded information, and ensures proper DRG groupings and reimbursement.

Skills

ICD-10-CM

UHDDS

DRG methodologies

IP Rehabilitation coding

Microsoft Office

Encoder/CAC

Education

Associate's Degree or equivalent experience

Tools

CAC

Encoder

Job description

Coding Specialist

Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

Position Summary:

Reviews inpatient clinical documentation to determine the appropriate assignment of alpha numeric diagnosis/procedure codes and Medicare Severity Diagnosis Related Groups (MS-DRG). Data is classified for internal and external statistical reporting, research, regulatory compliance and reimbursement.

Codes high dollar and more complex accounts including but not limited to, medical, surgical behavioral health, IP Rehabilitation and others.

Position Responsibilities:

Key Areas of Responsibility

1. Applies strong knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes for more complex accounts.
2. Analyzes medical records using the Uniform Hospital Discharge Data Set (UHDDS), interprets documentation and assigns proper International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) diagnoses and ICD-10-Procedural Classification System (PCS) operative procedure codes utilizing designated software to included Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material.
3. Reviews DRG assigned to each record. Enters coded/abstracted information into software, analyzes DRG groupings, and observes for appropriate DRG assignment.
4. Reviews high dollar and more complex cases including but not limited to, medical, surgical, behavioral health and IP Rehabilitation.
5. Applies IRF-PAI guidelines for IP Rehabilitation coding.
6. Adheres to all department coding procedures, policies, guidelines and quality standards.
7. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.
8. Meets revenue cycle goals (Key Performance Indicators (KPIs) and Productivity Standards).

Issue Resolution

1. Complete on a daily basis cases that have been assigned for review of edits, etc.

Communication

1. Collaborates with clinical documentation specialists (CDS) to determine appropriate DRG assignment for compliance and reimbursement purposes.
2. Collaborates with Quality Management and other departments (Billing Registration, etc.) as required.
3. Seeks clarification from attending physician in cases where documentation is absent, ambiguous, or contradictory.

Training

1. Assists in training and mentoring new coders to become acclimated to new environment, and understand internal coding policies and procedures

Working Relationships:

This position reports to Inpatient Coding Manager

Qualifications

Education

• Associate's Degree or equivalent experience

Experience

• Minimum: Two to three years of progressive on-the-job experience in an acute care hospital.
• Preferred: Two to four years of progressive on-the-job experience in an acute hospital.

Licensure, Certification, Registration

• Certified Coding Specialist (CCS) required and maintained thereafter.

Language Skills

• Strong written and verbal communication skills.

Knowledge, Skills and Ability Requirements:

Strong knowledge of:

• ICD‑10-CM diagnostic and ICD-10-PCS procedure codes
• UHDDS
• Various DRG methodologies (MS-DRG, APR-DRG, Tricare, etc.)
• IP Rehabilitation coding rules for IRF-PAI
• Clinical information related to areas of responsibility
• Microsoft Office Products; Word, Excel
• Encoder and/or CAC

Skills:

• Read, write and speak English proficiently.
• Strong analytical capabilities.
• Strong organizational skills.
• Proficiently read and interpret physician writing.

Strong ability to:

• Function independently.
• Handle multiple priorities.
• Listen and acknowledge ideas and expressions of others attentively.
• Converse clearly using appropriate verbal and body language.
• Collaborate with others to achieve a common goal through mutual cooperation.
• Influence others for positive and productive outcomes
• Work across the Hartford HealthCare System.