Lead Certified Inpatient Coding Specialist

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Responsible for reviewing and abstracting inpatient medical records, as well as, identifying and assigning accurate medical codes for diagnosis, procedures and services in an inpatient setting. The Coding Specialist ensures that all data elements required for federal or state reporting and billing are collected and included in the patient's demographic record. Typically reports to the Coding Manager.

Minimum Qualifications

Education: High School Diploma or GED required; Associates Degree in Health Information Management or any Healthcare Related Field preferred

Licenses/Certifications: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), or Certified Inpatient Coder (CIC) Coding Certification(s) from American Health Information Management Association (AHIMA) or Amercian Association of Professional Coders (AAPC) required.

Experience / Knowledge / Skills:

• Six (6) years of inpatient hospital coding experience required.
• Experience coding in a level 1 trauma facility/academic teaching facility strongly preferred.
• Effective oral and written communication skills.
• Strong knowledge of ICD-10-CM and PCS coding.
• Strong analytical skills necessary to interpret data contained in the health records and to assign appropriate codes.
• Strong knowledge of human anatomy, physiology, medical terminology and surgical terminology.
• Strong critical thinking, good judgment and decision making skills.
• Strong knowledge of coding compliance policies, official coding guidelines, regulatory requirements and internal policies and procedures affecting the coding process.
• Proficient in navigating a Windows-based application environment.

Principal Accountabilities

• Reviews medical record documentation to identify pertinent diagnosis/procedures that require code assignment for inpatient records and accurately code the diagnoses and procedures using ICD-10 coding conventions for the purpose of reimbursement, research, and compliance with federal regulations.
• Reviews the medical record to assure specificity of diagnoses, procedures, and appropriate reimbursement for hospital and professional charges.
• Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
• Keeps abreast of coding guidelines and reimbursement reporting guidelines and brings identified concerns to manager for resolution.
• Effectively assigns ICD-10 codes and DRGs to inpatient records.
• Responsible in maintaining 92% to 95% in ICD-10 and DRG assignment and consistently meet established productivity standards while keeping abstracting errors to a minimum.
• Mentors and trains newly hired Coders and provides ongoing training of Coding staff.
• Assists Coding Manager with special coding assignments or coding tasks to resolve unbilled issues.
• Serves as a resource for all coding related questions, responding in a timely manner to requests and questions from Coding staff.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
• Other duties as assigned.