Medical Coder

Luminis Health, Inc.; Orangeburg (SC); On-site; USD 43,000 - 58,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

Retirement Plan with employer match

Paid Time Off

Tuition Assistance Benefits

Employee Referral Program

Paid Holidays, Disability, and Life/AD

Wellness Programs

Employee Assistance Programs

Job summary

Luminis Health, Inc. is seeking an Inpatient Medical Coder to accurately code hospital inpatient accounts under supervision, ensuring proper reimbursement, research integrity, and regulatory compliance.

You will apply ICD-10-CM/PCS coding and participate in ongoing education to maintain credentials. Responsibilities include analyzing cases, obtaining clarifications from providers, maintaining timely workflows, and collaborating with departments to resolve billing issues.

Qualifications

• Must analyze inpatient records and assign ICD-10-CM/PCS codes accurately.
• Ability to query providers for clarity and consult CDIS staff for clinical issues.
• Maintain accuracy to prevent denials and ensure compliant coding.

Responsibilities

• Analyze inpatient cases and assign ICD-10 diagnostic and PCS codes.
• Query providers and coordinate with CDIS for clinical clarification.
• Monitor and manage daily work queues to meet billing timeframes.
• Maintain high accuracy to prevent denials and compliance issues.
• Review records to extract information for code assignments.
• Communicate with departments regarding billing and registration issues.
• Adhere to AHIMA standards and HIPAA privacy regulations.
• Utilize EHR and coding references to support accurate coding.
• Participate in ongoing education and DRG mismatch reviews.

Skills

Analytical skills

Organizational skills

Prioritization

Meeting deadlines

Customer service skills

Office procedures

Problem solving

Independent work

Medical terminology

Computer literacy

Typing

Education

High School diploma or equivalent

ICD-10-CM and CPT training

Associates or Bachelor's degree preferred

Tools

EHR software

Job description

Position Objective:

The Inpatient Medical Coder under the supervision of the Manager of Coding and Data Quality accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems.

Essential Job Duties:

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Analyzes inpatient cases, identifies and assigns ICD-10 diagnostic and PCS procedural codes for the purpose of reimbursement, research and compliance with federal and state regulations. Demonstrates comprehensive knowledge of coding nomenclature to ensure accurate MS-DRG MCC/CC and APR-DRG/SOI/ROM and POA assignments.

1. Utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. Sends coding queries to providers and communicates with CDIS’ when provider queries are clinical in nature.
2. Monitors assigned work on a daily basis in order to facilitate the billing process within the established timeframes within work queues. Codes and abstracts records within timeframes established for each patient type.
3. Maintain a high level of accuracy in code assignments to prevent claim denials, billing errors, and potential legal issues. Receives routine feedback on metrics.
4. Review medical records, including patient histories, examination findings, diagnoses, and treatment plans, to extract pertinent information for code assignments.
5. Communicates with various departments within the hospitals regarding billing and registration issues. Refers any problems to management timely, providing clear details.
6. Complies with AHIMA standards of ethical coding and coding compliance guidelines, including adherence to HIPAA (Health Insurance Portability and Accountability Act) privacy regulations.
7. Utilizes coding references, software tools, and electronic health records (EHR) to facilitate accurate and efficient code assignments.
8. Participate in ongoing education, training, and certification programs to enhance coding proficiency and maintain credentials. Participates in bi-monthly meetings related to DRG mismatches with CDIS.

Demonstrates support and compliance with Luminis Health Medical System mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections assigned by the manager.

Required Minimum Education.

The minimum level of education for this position includes:

High School graduate or equivalent. Formal ICD-10-CM and CPT training required. Associates or Bachelor’s degree preferred.

Required Minimum Experience

Minimum of one (1) year of inpatient acute care coding experience or two (2) years of acute care outpatient coding experience required. Experience with ICD-10-CM/ICD-10-PCS, MS-DRG/APR-DRG methodologies, inpatient reimbursement, and coding guidelines is preferred.

Required License/Certifications:

Candidates must possess a Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) credential; CCS is preferred at the time of hire and, if not held, must be obtained within one (1) year of employment.

Knowledge, Skills, Abilities:

Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.

Working Conditions, Equipment, Physical Demands:

Light work. Exerting up to twenty pounds of force occasionally, and/or up to ten pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.

There is reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.

Pay Range

$31.50—$42 USD

Luminis Health Benefits Overview:

• Medical, Dental, and Vision Insurance
• Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
• Paid Time Off
• Tuition Assistance Benefits
• Employee Referral Bonus Program
• Paid Holidays, Disability, and Life/AD&D for full-time employees
• Wellness Programs
• Employee Assistance Programs and more
• Benefit offerings based on employment status