Prebill Coder Specialist - Inpatient

600 Advocate Health, Inc.; United States; Remote; USD 94,702,000 - 142,124,000; Full time

Job summary

Advocate Health is seeking an experienced inpatient coder to review complex documentation and assign accurate codes using ICD-10-CM/PCS, CPT, and HCPCS. The role requires 7+ years in acute care inpatient coding and a HIM-related degree.

Collaborate with CDI and Quality teams to ensure proper DRG alignment and compliance with coding guidelines, while meeting productivity targets.

Qualifications

• Certification required: AAPC or AHIMA.
• 7+ years inpatient coding in acute care facility.
• Associate's Degree in Health Information Management or related field.

Responsibilities

• Review complex inpatient documentation to assign diagnosis and procedure codes using ICD-10-CM/PCS, CPT, and HCPCS.
• Ensure correct code selection per Official Coding Guidelines and regulations using EMR or coding software.
• Maintain compliance with departmental policies while prioritizing accuracy and productivity.
• Code high-dollar and long-stay cases across patient types with CDI collaboration.
• Engage with Clinical Documentation Improvement and Quality teams for DRG alignment.
• Support coding audits, education, and adherence to ethical coding standards.

Skills

ICD-10 Coding

CPT Coding

HCPCS Coding

EMR Systems

Education

Associate's Degree in Health Information Management

Tools

EMR Software

Coding Software

Job description

Department: 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Will support: Inpatient Schedule: Full time Monday - Friday, 8 hours a day, first shift Certification required: Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). Remote opportunity: Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range: $33.05 - $49.60

Major Responsibilities

• reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS.
• Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software.
• Adhere to organizational and internal department policies and procedures to ensure efficient work processes.
• Responsible for coding high dollar and long length of stay cases for all patient types.
• Expertise in query guidelines, and coding standards.
• Follow up and obtain clarification of inaccurate documentation as appropriate.
• Serves as a subject matter expert to Coding department leaders and peers.
• Recommends modifications to current policies and procedures as needed to coincide with government regulations.
• Maintain continuing education by attending webinars, reviewing updated CPT assistant guidelines and updated coding clinics.
• Knowledgeable in researching coding related topics and issues.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines.
• Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement.
• Collaborates with the Clinical Documentation Improvement and Quality teams, to ensure a match in the DRG and reconciles each Medicare case with the working DRGs from a CDI perspective.
• Responsible for clinician communication related to disease processes on a clinical level to ensure accurate coding.
• Participates in payer audits and meetings by acting as a resource for coding-related audits, as requested.
• Attends meetings with clinical teams regarding updates in codes for complex specialties.
• Maintains the confidentiality of patient records.
• Reports any perceived non-compliant practices to the coding leader or compliance officer.
• Meets and exceeds departmental quality (95% or more) and productivity standards (100%).
• Achieves productivity expectations to support discharged not final billed (DNFB).
• Performs any other assigned duties since the duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive.
• Management retains the right to add or change duties at any time.

Licensure, Registration, and/or Certification Required

Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA)

Education Required

Associate's Degree in Health Information Management or related field.

Experience Required

Typically requires 7 years' experience inpatient coding in acute care tertiary facility that includes experience in revenue cycle processes, Clinical Documentation Improvement, Research and health information workflows.

Knowledge, Skills & Abilities Required

Advanced profiency of ICD, CPT and HCPCS coding guidelines. Advanced knowledge of medical terminology, anatomy and physiology. Excellent computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications. Excellent communication (oral and written) and interpersonal skills. Excellent organization, prioritization, and reading comprehension skills. Excellent analytical skills, with a high attention to detail. Ability to work independently and exercise independent judgment and decision making. Ability to meet deadlines while working in a fast-paced environment. Ability to take initiative and work collaboratively with others.

Physical Requirements and Working Conditions

Exposed to a normal office environment. Must be able to sit for extended periods of time. Must be able tocontinuously concentrate. Position may be required to travel to other sites; therefore, may be exposed to road and weather hazards. Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

#REMOTE #LI-REMOTE

Our Commitment to You

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.; please ask a Recruiter for more information during an interview.

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits. This is Transformation One shared purpose brought us together. Now, as one of the 10 largest not-for-profit, integrated health systems in the United States, our combined strength and stability drives us forward. Starting with You Caring for nearly 3 million people has inspired a transformation. One in which the patient’s experience guides our vision and empowers us to offer new possibilities in our communities.

Reshaping Access

What is access? It’s offering more sites of care than any other health system in the Midwest. But there’s a new frontier. Access is exploring the latest technologies to deliver care to patients exactly where they are and exactly when they need it.

Inspiring Professionals

With our dynamically inclusive workforce and strong connections to the places where we live and work, we’ll touch more lives and contribute to stronger and more vibrant communities.

Transforming Care

We’re redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in:

• Cardiovascular Care
• Neurosciences
• Gynecology
• Oncology
• Pediatrics
• Primary Care
• Neurology
• Geriatrics
• Trauma Care