Inpatient Coder III

Nuvance Health Position

Position at Nuvance Health

Must reside in AL, AZ, CO, CT, DE, FL, GA, IL, IN, KS, MA, MD, ME, MI, MS, NC, NH, NJ, NY, OH, PA, SC, TN, TX, VA

At Nuvance Health, we enjoy the benefits of a two-state system as we cultivate an inclusive culture where everyone feels welcomed, respected and supported. Together, we are a team of 15,000+ strong hearts and open minds. If you share our values of connected, personal, agile and imaginative, we invite you to discover what's possible for you and your career.

Summary:

Appropriately analyzes and codes complex inpatient records. Position requires high-level expertise in coding and documentation guidelines, coding clinics and knowledge of MS DRGs, CC/MCC for appropriate reimbursement and compliance. Acts as a recognized subject-matter expert, leading DRG validation, revenue integrity analyses, and strategic coding compliance projects across the department.

Responsibilities:

1. Performs ICD-10-CM diagnostic and ICD-10 PCS procedural coding to maintain an accurate database & ensure accurate coding at minimum accuracy rate of 95%.
2. Competent in the utilization of an electronic medical record, and computerized coding/abstracting systems.
3. Applies knowledge of diagnosis related group assignment, official Coding guidelines, comorbidity/complication coding, Hospital acquired conditions, accurate present on admission assignment, and current American Hospital Association coding clinic guidance.
4. Effectively and professionally communicates with providers and/or CDI staff when necessary to clarify documentation in order to assign accurate diagnoses and procedures in order to calculate the appropriate diagnosis related group and severity of illness/risk of mortality.
5. Ability to code using either 3M encoder or ICD-10-CM/ICD10 PCS codebook.
6. Mentors and trains junior coders.
7. Performs audits as assigned by the coding manager.
8. Demonstrates advanced knowledge of the impact of coding decisions on revenue cycle, including the ability to assist in appealing payer denials.
9. Responds to all business office questions regarding diagnoses and procedures in a timely manner.
10. May assist as needed in other coding areas.
11. Attends and participates in required hospital education programs in order to maintain and enhance their coding skills and stay abreast of changes in codes, coding guidelines and regulations.
12. Maintains certified coding credentials in accordance with the certified coding requirements and demonstrates annual compliance.
13. Fulfills all compliance responsibilities related to the position.
14. Maintain and model the organizations values
15. Demonstrates regular, reliable and predictable attendance
16. Performs other duties as assigned.

Requirements: Essential/Required: Certified Coding Specialist (AHIMA), or Certified Inpatient Coder (AAPC) Required: Specialized training in medical terminology, ICD-10-CM/ICD-10 PCS coding. Ability to decipher operative reports, medication orders & various medical records in the appropriate selection of codes. Experience in acute care coding inpatient records. Minimum Experience: Five years demonstrated coding experience in appropriate application of coding and documentation guidelines Desired: Course work in Anatomy and Physiology and knowledge of CPT codes. Education Derived Education Essential: * HS Graduate or Equivalent

Working Conditions:

Manual: Little or no manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment: Generally pleasant working conditions