Inpatient Coder II, HB coding

Northwestern Medicine Central DuPage Hospital; Chicago (IL); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Benefits package

Equal opportunity employer

Job summary

Northwestern Medicine Central DuPage Hospital is seeking an Inpatient Coder II, HB Coding to perform complex ICD-10-CM/PCS coding for acute care discharges in accordance with official guidelines and CDI collaboration.

You will review records, assign POA values, utilize CAC software, support DRG determinations, and help optimize reimbursement while maintaining productivity and quality standards. RHIA/RHIT/CCS and AHIMA membership are preferred with 3 years of inpatient coding experience.

Qualifications

• 3 years of inpatient coding experience in an acute healthcare setting
• RHIA, RHIT or CCS credential
• AHIMA membership preferred
• Associate's degree preferred
• RHIA/RHIT with CCS or CDIP/CCDS credential is a plus

Responsibilities

• Assign ICD-10-CM and ICD-10-PCS codes for complex inpatient discharges
• Assign POA values to secondary diagnoses for quality metrics
• Review provider notes and CDI input to ensure accurate coding
• Use CAC software and resources to select appropriate codes
• Validate discharge disposition and impact on Medicare reimbursement
• Sequence codes to support MS-DRG/APR-DRG decisions
• Educate CDI on coding guidelines and conventions
• Interpret health records to determine principal and secondary diagnoses

Skills

Inpatient coding

POA assignment

Clinical documentation

Education

RHIA/RHIT/CCS

AHIMA membership

Associate's degree

Tools

CAC software

DRG knowledge

Job description

Inpatient Coder II, HB Coding

The Inpatient Coder II reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

The Inpatient Coder II is the coding and reimbursement expert for ICD-10-CM diagnosis coding and ICD-10-PCS procedure coding for complex inpatient acute care discharges. Possesses a strong foundation in coding conventions, instructions, Official Guidelines for Coding and Reporting and Coding Clinics. Has a deep understanding of disease process, anatomy/physiology, pharmacology and medical terminology.

RESPONSIBILITIES:

• Utilizes technical coding expertise to assign appropriate ICD-10-CM and ICD-10-PCS codes to complex inpatient visit types. Complexity is measured by a Case Mix Index (CMI) and Coder II's typically see average CMI's of 2.2609. This index score demonstrates higher patient complexity and acuity.
• Utilizes expertise in clinical disease process and documentation, to assign Present on Admission (POA) values to all secondary diagnoses for quality metrics and reporting.
• Thoroughly reviews the provider notes within the health record and the Findings from the Clinical Documentation Nurse in the Clinical Documentation Improvement (CDI) Department who concurrently reviewed the record and provide their clinical insight on the diagnoses.
• Utilizes resources within CAC (Computerized Assisted Coding) software to efficiently review documentation and select or assign ICD-10-CM/PCS codes using autosuggestion or annotation features.
• Reviews Discharge Planning and nursing documentation to validate and correct when necessary, the Discharge Disposition which impacts reimbursement under Medicare's Post-Acute Transfer Policy.
• Utilizes knowledge of MS-DRG's, APR-DRG's, AHRQ Elixhauser risk adjustment to sequence the appropriate ICD-10-CM codes within the top 24 fields to ensure correct reimbursement and NM's ranking in US News and World Report.
• Collaborate with CDI on approximately 45% of discharges regarding the final MS or APR DRG and comorbidity diagnoses.
• Educates CDI on regulatory guidelines, Coding Clinics and conventions to report appropriate ICD-10-CM diagnoses.
• Interprets health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, medical terminology to determine the Principal Diagnosis, secondary diagnoses and procedures.
• Follows the ICD-10-CM Official Guidelines for Coding and Reporting, ICD-10-PCS Official Guidelines for Coding and Reporting, Coding Clinic for ICD-10-CM and ICD-10-PCS, coding conventions and instructional notes to assign the appropriate diagnoses and procedures.
• Utilizes coding expertise and knowledge to write appeal letters in response to payor DRG downgrade notices.
• Resolves Nosology Messages/Alerts and Coding Validation Warning/Errors.
• Meets established coding productivity and quality standards.

Qualifications

Minimum Requirements:

Certification:

• RHIA, RHIT or CCS credential

• AHIMA membership

Experience:

• 3 years of inpatient coding experience in an acute healthcare setting

Preferred:

• Associate's degree in related field
• RHIA, RHIT with CCS or CDIP/CCDS credential
• 4 years of inpatient coding experience in a teaching hospital

Additional Information

Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.

• We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events.