Inpatient Coder I - HB Inpatient Coding, Full-time, Days

Job Description

The

The Inpatient Coder I, coding acute care inpatient, must possess knowledge and technical expertise of ICD-10-CM/PCS diagnosis and procedure coding.

• Understands coding conventions/instructions, Official Guidelines for Coding, and Reporting and Coding Clinics.
• Has a good understanding of disease process, anatomy/physiology, pharmacology and medical terminology.
• Understands APR and MS-DRG reimbursement methodology for acute care coding.
• For inpatient rehabilitation coding, must possess knowledge and technical expertise of ICD-10-CM diagnosis coding.
• Must possess a blended understanding of the Official Guidelines for Coding and Reporting, and guidelines specific to Inpatient Rehab Facilities.
• Must understand IRF-PAI (Inpatient Rehabilitation Facility Patient Assessment Instrument) guidelines as it relates to coding.
• Must have a working knowledge of the IGC (Impairment Group Codes) and RIC (Rehabilitation Impairment Categories) as it relates to the primary diagnosis selection and claim reimbursement.
• Performs a review of medical record documentation within CAC (computer assisted coding) or Epic to identify the appropriate principal/primary diagnosis, CC/MCC/tier, (co-morbidity/complication, major co-morbidity/complication, tier 1, 2, 3) as these diagnoses impact reimbursement. Also, identify other secondary diagnoses and all appropriate procedures.
• Navigates Epics Doc Review, Hospital Chart or Chart Review outside of CAC when necessary.
• Utilizes 3Ms encoder resources to ensure optimal coding accuracy.
• Optimizes CAC to ensure coding efficiency.
• Collaborates occasionally with Clinical Documentation Specialists when there is a diagnosis or DRGmismatch or query opportunity to ensure clarity and accuracy of medical record documentation.
• Articulates rationale for coding selections when necessary, i.e. data quality audit.
• Maintains diagnosis, procedure, DRG and overall accuracy within department standard of 95% or better.
• Maintains productivity standard within department standard of 90% or better

Qualifications

• 1 year of inpatient coding experience in an acute healthcare or inpatient rehabilitation setting or progressive coding experience internally. Must have formal training in PCS coding.
• RHIA, RHIT or CCS credential.
• AHIMA membership

• Associate's degree in related field.
• 2 years of inpatient coding experience in an acute healthcare setting that includes a teaching hospital

Additional Information

Northwestern Medicine is an affirmative action/equal opportunity employer 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.