Coding Specialist II - Inpatient

POSITION SUMMARY:

Assign diagnosis and procedure codes using the appropriate coding classification system to reflect the care and services rendered to the patients in the emergency department, ancillary, and outpatient surgery settings. Ensure the accurate selection of the principal diagnosis and procedure and all other significant diagnoses and procedures. Abstract hospital-defined data from records for data collection purposes. Ensure compliance with official guidelines, AHA Coding Clinic, AMA CPT Assistant and Guidelines, AHIMA Standards of Ethical Coding and LifePoint Health Support Center (HSC) policies and procedures.

ESSENTIAL FUNCTIONS:

Inpatient coders will assign ICD-10-CM and ICD-10-PCS codes correctly with a coding error rate of less than 5% in accordance with established guidelines for reimbursement and statistical data.

Outpatient coders will assign ICD-10-CM, CPT and HCPCS codes correctly with a coding error rate of less than 5% in accordance with established guidelines for reimbursement and statistical data.

Maintain quarterly minimum 95% coding accuracy.

Follows department workflow for service type to include addressing compliance reviews. Contacts physicians and/or ancillary departments when additional information is needed to accurately code the record.

Prioritizes coding functions to assure records are coded within facility defined number of days from discharge. Collaborates with the team to maintain and exceed DNFC goals while maintaining good employee relations.

Meets coding productivity standards on a consistent basis as indicated by HSC standards.

Submits physician queries when clarification of documentation is needed.

Refers coding questions to coding auditors, coding managers and/or coding leads. For those cases where the diagnosis is obscure, determines the most appropriate diagnosis after a thorough review of the medical record and queries the physician.

Decreases pending accounts with timely follow up. Daily review and response to Business Office holds.

Accurately enters code hold reasons into abstracting system.

Identifies any patient type admission order discrepancy or discharge status discrepancy and works with case managers and admitting to code the account with the correct status.

Uses independent discretion/decision making while effectively working alone.

Attends educational webinars, conference calls, other coding seminars, and participates in all formal and informal coding discussions. Complete all assigned compliance courses within assigned period of time.

Maintain at least twenty (20) continuing education hours annually and maintain required credentials.

Conforms to AHIMA’s Code of Ethics and Standards of Ethical Coding, LifePoint Attendance Policy and ensures patient/employee privacy and dignity by maintaining confidentiality with no infractions.

Inpatient coders must be familiar with Diagnosis Related Groups (DRGs), the Inpatient Prospective Payment System (IPPS), and other medical necessity/compliance guidelines for billing and coding.

Outpatient coders must be familiar with Ambulatory Payment Groups (APGs), Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative guidelines, Local and National Coverage Decisions, and other medical necessity/compliance guidelines for billing and coding.

Other related job tasks or responsibilities as assigned.

Additional Information:

Position serves both internal co-workers and external customers, clients, and contractors.

Access to and/or works with sensitive and/or confidential information.

KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education: Associate degree in health-related field preferred.

Experience: Minimum of five years coding experience in an acute care hospital setting.

Certifications: Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT) required for inpatient positions. Certified Coding Specialist (CCS), Certified Outpatient Coder (COC) or Registered Health Information Technician (RHIT) required for outpatient positions.

Licenses: N/A

Skills and Abilities:

Candidate must possess excellent organizational skills and communication skills.

Candidate must be adept in utilizing computer programs and Internet.

Candidate must be self-motivated and possess the ability to work independently.

Candidate must be able to successfully pass coding assessment with 80% or higher.

PHYSICAL AND MENTAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

While performing the duties of this job, the employee is occasionally required to sit for extended periods of time; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; talk or hear; taste or smell. Repetitive motion of upper body required for extended use of computer. Required specific vision abilities include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT AND TRAVEL REQUIREMENTS:

Work environment characteristics described here are representative of those that an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job responsibilities.

Position is remote based.

Travel – none expected.

Normal business hours are 8 a.m. – 5 p.m., Monday-Friday. However, schedules may vary in accordance with business necessity.