Inpatient DRG Coder Specialist

5 days ago


Albany, New York, United States Intermountain Health Full time
Job Title: Inpatient DRG Coder

Job Summary:

We are seeking an experienced Inpatient DRG Coder to join our team at Intermountain Health. As an Inpatient DRG Coder, you will be responsible for coding and abstracting hospital health record data using International Classification of Diseases Clinical Modification and Procedure Coding System (ICD-10-CM and PCS) at an advanced level of complexity.

Key Responsibilities:
  1. Codes and abstracts hospital health record data using ICD-10-CM and PCS at an advanced level of complexity.

  2. Audits and edits results of data provided by technology tools and resolves edits to send out a clean and accurate claim.

  3. Collaborates with internal patient access to acquire correct and compliant diagnosis(es) to meet Advance Beneficiary Notice of Noncoverage (ABN) requirements and compliant billing.

  4. Maintains assigned work queues within defined processing time, meets productivity standards, and meets quality standards of 95% accuracy or better.

  5. Utilizes critical thinking thought process to assign appropriate clinical diagnosis and procedure codes in accordance with nationally recognized guidelines.

  6. Verifies data abstracted and entered from the electronic health record (EHR). Ensures integrity of the database for internal and external data reporting.

  7. Responds promptly to inquiries from revenue services related to the use of codes and modifiers within the billing process to assure accuracy and avoid delays in the billing process.

  8. Adheres to all internal and external compliance guidelines.

  9. Participates in continuing education programs to maintain an understanding of anatomy, physiology, medical terminology, disease processes, and surgical techniques to support the effective application of coding guidelines and maintains credentials.

  10. Stays abreast of coding guidelines, reimbursement methodologies, and regulatory compliance.

  11. Assists as needed with billing/audit questions to ensure accurate reimbursement, facility inquiries, education, statistical analysis, and the processing of internal audit reviews.

  12. Identifies the need to clarify documentation in the medical record and communicates with physicians using the appropriate "query" tools according to the American Health Information Management Association (AHIMA) Guidelines for Achieving a Compliant Query Practice.

  13. Promotes the mission, vision, and values of Intermountain Health, and abides by service behavior standards.

Requirements:
  • Coding credential from AHIMA or American Academy of Professional Coders (AAPC) required OR ten (10) years of acute care inpatient facility coding experience.

  • Ability to work independently in a remote environment.

  • Demonstrates attention to detail for accuracy requirements.

Preferred Qualifications:
  • Minimum of three (3) years acute care facility coding experience which includes both ICD-10-CM & PCS coding with multidisciplinary service lines.

  • Understanding of billing, hospital reimbursement, and compliance background.

  • Ability to communicate effectively and diplomatically within a multi-functional team.

  • Experience with EPIC EHR and 3M 360 CAC, using 3M automation tools.

  • Experience with Microsoft Suite (Excel, Word, Outlook).

Physical Requirements:

Hearing/listening, lifting, manual dexterity, pulling/pushing, seeing, sitting, speaking, squatting/kneeling, standing, and walking.

Location:

Peaks Regional Office

Work City:

Broomfield

Work State:

Colorado

Scheduled Weekly Hours:

0

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$37.12

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://www.intermountainhealthcare.org/careers/benefits/) and for our Colorado, Montana, and Kansas based caregivers (https://www.intermountainhealthcare.org/careers/benefits/colorado-montana-kansas/); and our commitment to diversity, equity, and inclusion (https://www.intermountainhealthcare.org/about/diversity-equity-inclusion/).

Intermountain Health is an equal opportunity employer.

Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.



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