Position Summary Assigns appropriate codes to reflect all diagnoses and procedures extrapolated from physician and appropriate nursing documentation during a patient encounter according to the most current coding methodologies, including ICD-10-CM/PCS, resulting in appropriate reimbursement. Abstracts required data to input into the Medical Center’s computerized database, converts all patient visits and encounters into appropriate DRG (Diagnosis Related Group) assignments to correctly submit the optimal reimbursement for each patient encounter coded. Assists the IP Coding Manager with administrative duties such as assignment of coding work, analysis of the unbilled report, and other duties as assigned.
Essential Responsibilities / Duties Assists IP Coding Manager with assignment of work to coders, analysis of the daily unbilled report, and follow‑up on unanswered physician queries and missing documentation.
Assists PFS in researching unbilled accounts and updating incorrect discharge dispositions.
Assists Coding Manager in orienting, training, and mentoring staff; provides ongoing education as needed.
Serves as a resource and subject matter expert to outside departments.
Troubleshoots system issues with 3M encoder and EPIC.
Performs special projects as needed.
Reviews patient medical records and abstracts medical data that identifies all diagnoses and procedures.
Codes diagnoses, procedures, and appropriate modifiers from the medical record documentation using ICD-10-CM/PCS classification systems.
Sequences diagnoses, procedures, and complications following ICD-10-CM/PCS and the UHDDS; adheres to official guidelines for coding and reporting.
Consults with the CDCI team to obtain clarification of medical record information.
Assigns grouper codes to each record according to patient type and financial class.
Enters coded/abstracted information in grouper, analyzes groupings, and assigns the appropriate grouper for accurate reimbursement.
Maintains coding accuracy rate of 95% or better and meets productivity standards set forth in departmental policies and procedures.
Coordinates with HIM to track missing provider documentation so that all records can be coded and billed in a timely fashion.
Maintains professional skills and knowledge of coding through attendance at in‑service programs, conferences, workshops, and review of current literature.
Assists in orienting new personnel to department coding procedures.
Serves as a resource for Revenue Cycle Analysts in working claims in scrubber to clear for billing.
Follows hospital behavioral standards, infection control and safety procedures.
Performs other duties as needed.
Job Requirements Education: Associate’s Degree in Health Information, Medical Records or a comparable program, or equivalent combination of education and experience.
Credentials: Inpatient CCS, RHIT or RHIA from AHIMA; CCS requires inpatient coding experience before examination; RHIT and RHIA require associate’s and bachelor’s degrees respectively.
Experience: Minimum of five years inpatient coding experience in a Level1 Trauma, Teaching Facility.
Knowledge & Skills: In‑depth knowledge of medical terminology, ICD‑10‑CM/PCS, CPT‑4, and DRG systems (CMS‑DRGs, AP‑DRG, APR‑DRGs); basic concepts of anatomy, physiology, pathology; strong computer skills with Microsoft applications; excellent organizational and multitasking abilities; accurate and detail oriented, problem‑solving skills; ability to collaborate with healthcare team; strict confidentiality and HIPAA compliance; solid communication skills, oral and written.
Compensation $62,500.00 – $91,000.00 (range based on qualifications). Total compensation includes medical, dental, vision, pharmacy benefits, discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well‑being.
Equal Opportunity Employer Boston Medical Center is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or expression.
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