Inpatient Coder IV

Inpatient Coder IV

Mercy Healthcare, Rancho Cordova, California

The Coder IV is a member of the Health Information Management Team responsible for ensuring the accuracy and completeness of clinical coding, validating the information in the databases for outcome management and specialty registries, across the entire integrated healthcare system.

The purpose of this position is to apply the appropriate diagnostic and procedural codes to individual patient health information records for data retrieval, analysis and claims processing. This position is expected to perform duties in alignment with the mission and policies within the Dignity Health organization, TJC, CMS, and other regulatory agencies.

Principle Duties and Accountabilities:

• Assign codes for diagnoses, treatments, and procedures according to the appropriate classification system for inpatient admissions.
• Can also code ancillary, emergency department, same-day surgery, and observation charts if needed.
• Review provider documentation to determine the principal diagnosis, co-morbidities and complications, secondary conditions and surgical procedures following official coding guidelines.
• Utilize technical coding principals and APC reimbursement expertise to assign appropriate ICD-IO-CM diagnoses, ICD-IO-PCS as appropriate, and CPT-4 for procedures.
• Understanding of ICD10 Coding in relation to DRGs
• Abstract additional data elements during the chart review process when coding, as needed
• Utilize technical coding principals and MS-DRG reimbursement expertise to assign appropriate ICD-10- CM diagnoses and ICD- IO-PCS procedures.
• Ensure accurate coding by clarifying diagnosis _and procedural information through an established query process if necessary.
• Assign Present on Admission (POA) value for inpatient diagnoses.
• Extract required information from source documentation and enter into encoder and abstracting system.
• Identifies non-payment conditions; Hospital-Acquired Conditions (HAC), Patient Safety Indicators (PSI) following, report through established procedures.
• Collaborate in the DRG Mismatch process with the Clinical Documentation Improvement team.
• Review documentation to verify and when necessary, correct the patient disposition upon discharge.
• Prioritize work to ensure the timeframe of medical record coding meets regulatory requirements.
• Serve as a resource for coding related questions as appropriate.
• Adhere to and maintain required levels of performance in both Coding accuracy and productivity.
• Review and maintain a record of charts coded, held, and/or missing
• Provide documentation feedback to Providers, as needed
• Participate in Coding department meetings and educational events.
• Meet performance and quality standards at the Coder III level.
• Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
• Other duties as assigned that have a direct impact on our ability to decrease the DNFB and support Revenue Cycle, including but not limited to charge validation, observation calculations, etc.

Job Requirements:

This is a remote position but selected candidate must reside in California.

Minimum Qualifications:

• High School Diploma or equivalent.
• Completion of an AHIMA or APPC accredited coding certification program that includes courses that are critical to coding success such as Anatomy and physiology, pathophysiology, pharmacology, Anatomy I Physiology, Medical Terminology, and ICD-10 and CPT coding courses, etc.
• Have and maintain current coding credential from AHIMA or AAPC (RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H).
• Three years of relevant coding and abstracting experience or an equivalent combination of education and experience required in an acute care hospital setting.
• A minimum of 3 years Inpatient medical coding experience (Hospital, Facility, etc). *
• Must have ICD-10 coding experience.
• Ability to use a PC in a Windows environment, including MS Word and EMR systems.
• Ability to pass coding technical assessment.

* One year of experience will be waived for those who have attended the Dignity Health Coding Apprenticeship Program.

Preferred Qualifications:

• Experience with various Encoder systems (i.e., OptumCAC, Cemer).
• Intermediate level of Microsoft Excel.
• Experience with coding and charge validation.

Dignity Health, one of the nation's largest health care systems, is a 22-state network of more than 9,000 physicians, 63,000 employees, and 400 care centers, including hospitals, urgent and occupational care, imaging and surgery centers, home health, and primary care clinics. Headquartered in San Francisco, Dignity Health is dedicated to providing compassionate, high-quality, and affordable patient-centered care with special attention to the poor and underserved.

One Community. One Mission. One California

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.

CommonSpirit Health is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law.

CommonSpirit Health will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen.

Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health participates in E-Verify.