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Inpatient Coder - Remote

Job ID: 4658157
Updated: September 5, 2018
Geographic Location: 
Department: Coding
Full/Part Time: Full-Time
Shift: Days
Standard Hours: 40
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Job Summary

Overview:

This position is located remotely with Mercy Health, a client of Ensemble Health Partners. To learn more about Mercy, click the link below to apply.

Advanced coding position that requires review of medical record documentation and accurately assigns ICD-9-CM, ICD-10-CM, ICD-10 PCS, CPT IV codes, as well as assignment of the Medicare Severity - Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstract specific data elements for each case in compliance with federal regulations. This position codes all types of records to include inpatients and outpatient visits. The position follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communcations.  Utilizing 3M 360 in accordance with estalbished workflow.   Follows Mercy policies and procedures and maintains required quality and productivity standards.

Essential Functions:

  • Reviews medical record documentation and accurately assigns appropriate ICD-9 / ICD-10 diagnoses and procedure codes, as well as CPT IV, and HCPCS codes, leading to the assignment of the correct Medicare Severity - Diagnosis Related Group, (MS-DRG) or All Patient Refined - Diagnosis Related Group, (APR-DRG,) and assuring assigned codes support the documented reason for the visit and medical necessity of outpatient accounts. The Advanced Coding Specialist is responsible for verification of the patient's discharge disposition and to ensure the appropriate present on admission, (POA) indicators are assigned to each code. The assigned codes must support the reason for the visit that is documented by the provider in order to support the care provided.
  • Correctly abstract required data per facility specifications.
  • Responsible to assist with writing appeals for Diagnosis Related Group, (DRG) denials in order to support the assigned Diagnosis Related Group, (DRG) and to address the clinical documentation utlized in the decision making process to support the validity of the assigned codes.
  • Responsible for monitoring of accounts that are Discharged Not Final Billed accounts, failed claims, stop bills, and epremis and as a team, ensure timely, compliant processing of all accounts through the billing system.
  • Collaborates with Clinical Documentation (CDE) Specialists and members of the medical staff to ensure completeness of documentation in the charts so that appropriate codes, and ultimately the correct Diagnosis Related Group, (DRG,) may be assigned.
  • Responsible to ensure accuracy and maintain established quality and productivity standards and  key performance indicators established for 3M 360 CAC for CRS & Direct Code
  • Remain abreast of current Centers for Medicare and Medicaid Services, (CMS) requirements as well as Correct Coding Initiatives, (CCI) edits, Hospital Acquired Conditions, (HACs) and when applicable, National Coverage Determinations, (NCDs) and Local Coverage Determinations, (LCDs,) including the addition of appropriate modifiers to ensure a clean claim the first time through.
  • Maintains competency and accuracy while utilizing tools of the trade, such as the 3M encoder, Computer Assisted Coding, (CAC,) Clinical Documentation Improvement System, (CDIS) and abstracting systems, and all reference materials.  Reports inaccuraceis found in Coding Software to HIM Coding Manager/Supervisor, reports any potential unethical and/or fradulent activity per compliance policy. 
  • Follows all established Mercy Health policies and procedures to include abiding by paid time off, (PTO) requirements.
  • Training/Mentoring - SMART Responsibilities where applicable
  • Other duties as assigned.

Qualifications - Minimum

  • Completion of Coding Curriculum and one year acute care coding experience required
  • RHIA or RHIT or CCS or CIC or CCA or CPC at point of hire.  If RHIA or RHIT or CCA upon hire without CPC, CCS, CIC, will be required to acquire CIC or CCS and CRCR within one year of hire
  • Computer Assisted Coding, (CAC) and Clinical Documentation Improvement System (CDIS) tools highly preferred
  • 2 year/Associates Degree in HIM/Coding required at minimum with a 4 year/Bachelors Degree HIM/Coding preferred

Shift and Job Schedule

Full-Time, 40 hours/week, Days.

This is a fully remote position.

Equal Employment Opportunity

It is our policy to  abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.

About Us

This position will be a part of the revenue cycle team at Ensemble Health Partners - a wholly owned subsidiary of Mercy Health. Ensemble Health Partners specializes in providing revenue cycle solutions and creating real value for its clients by building relationships, reducing revenue cycle spend and delivering exceptional results. Ensemble partners with hospitals across the United States to make real and lasting improvements that impact the bottom line.

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