Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.
Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.
The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).
Pay Range:
$64,625.60 - $84,448.00
Scheduled Weekly Hours:
40
Position Overview
CANDIDATES MUST RESIDE IN THE NEW JERSEY/PENNSYLVANIA AREA
Hospital Coder Inpatient Senior Coder is an expert-level coding professional responsible for accurately reviewing and coding complex inpatient medical records using ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and appropriate MS-DRG/APR-DRG grouping methodologies. This role serves as a subject matter expert within the coding department, performing second level reviews, mentoring staff, and collaboration with Clinical Documentation Improvement (CDI), quality, and revenue cycle teams to ensure optimal reimbursement and compliance with regulatory guidelines.
MINIMUM REQUIREMENTS
Education: High School diploma or equivalent. Associate's degree preferred. Certified Coding Specialist (CCS) required.
Experience: Four years medical or hospital coding experience.
Other Credentials: CCS
Knowledge and Skills: Prior experience with an encoder and EMR computer systems. Possesses excellent organizational, interpersonal, verbal, and written communication skills.
Special Training: Instructed in DRG assignment and application of requirements needed to comply with federal and local regulations.
Mental, Behavioral and Emotional Abilities: Ability to effectively manage multiple projects simultaneously and ability to respond quickly in a fast-paced environment.
Usual Work Day: 8 Hours
Reporting Relationships
Does this position formally supervise employees? No
If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.
ESSENTIAL FUNCTIONS
Responsible for accurately reviewing and coding complex inpatient medical records using ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and appropriate MS-DRG/APR-DRG grouping methodologies.
Acts as lead resource on new regulatory updates, ICD-10 CM and Procedure code changes, and reimbursement methodologies. Acts as the subject matter expert (SME) on DRGs.
Assists with analyzing coding data to identify trends, opportunities for improvement and potential risk areas.
Scrutinizes medical record documentation to identify trends, knowledge gaps, and documentation deficiencies.
Verifies accurate assignment of diagnoses and procedures within the medical record to comply with federal and state regulations.
Participates in creating a collaborative environment to promote excellence in coding and outcomes.
Supports provider education and collaborates with revenue cycle team to ensure optimal reimbursement and compliance with all regulatory guidelines. Collaborates with Clinical Documentation Improvement (CDI), revenue integrity, billing, and compliance departments to ensure optimal DRG assignment.
Provides internal monitoring of coding and related data and provides detailed feedback to inpatient coding staff as well as leadership. Assists in developing and maintaining coding policies, reference materials, and workflow improvements.
Supports preparation for external audits and ensure corrective actions are implemented.
Develops and delivers departmental specific training sessions, coding updates, and targeted education based on audit findings.
Research complex coding scenarios and payer rules; communicates updates to the team. Assists in the management of the DNFB to ensure minimal number of uncoded days.
Maintains coding credentials and up-to-date knowledge of inpatient coding changes.
Provides guidance in daily workflow, prioritization, and problem resolution.
Adapts to changing department demands required to maintain high level of performance.
Performs other duties as assigned.
PHYSICAL DEMANDS AND WORK ENVIRONMENT
Frequent physical demands include:
Occasional physical demands include: Standing , Walking , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Talk or Hear
Continuous physical demands include: Sitting , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion
Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.
Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate Hearing
Anticipated Occupational Exposure Risks Include the following: N/A
IND123.
This position is eligible for the following benefits: