Pre-Bill Coder Specialist – Inpatient
Job Description:
• Prioritizes and codes and abstracts high dollar charts, day after discharge, as well as interim charts
• Reviews complex medical documentation at a highly skilled and proficient level from clinicians, qualified health professionals and hospitals to assign diagnosis and procedure codes utilizing ICD CM/PCS, CPT, and HCPCS
• Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software
• Assigns codes for present on admission, research, Hospital acquired Conditions and Core Measure Indicators for all diagnoses both concurrently and post-discharge
• Collaborates with other departments to clarify pre-bill coding documentation issues such for inpatient and outpatient to insure reimbursement and clinical outcomes
• Works claim edits for all patient types and may codes consecutive/combined accounts to comply with the 72-hour rule and other account combine scenarios
• Completes informal peer-review on inpatient and outpatient coders
• Tracks and trends quality information from internal and external sources to partner with the educational team on opportunities
• Communicates with Medical Staff, CDI, Post -bill for documentation clarification
• Utilizes EMR communication tools to track missing documentation on inpatient queries that require follow-up to facilitate coding in a timely fashion
• Partners with HIM, Patient Accounts, and Integrity, when needed, to help resolve issues affecting reimbursement and outcomes
• Maintains current knowledge of changes in Inpatient coding and reimbursement guidelines and regulations as well as new applications or settings for coding all types of patients
• Must be able to use critical decision-making skills to determine when to query to clarify documentation independently for outcomes, reimbursement and benchmarking
Requirements:
• Two Year associate degree or equivalent work experience
• Five to Seven years of inpatient coding experience in an acute care inpatient setting in an Academic Inpatient Care Tertiary Facility
• Advanced proficiency of ICD, CPT and HCPCS coding guidelines
• Advanced knowledge of medical terminology, anatomy and physiology
• Excellent computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications
• Excellent organization, prioritization, and reading comprehension skills
• Excellent analytical skills, with a high attention to detail
• Ability to work independently and exercise independent judgment and decision making
• Ability to meet deadlines while working in a fast-paced environment
• Ability to take initiative and work collaboratively with others
Benefits:
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program
Apply Now
Apply Now
• Prioritizes and codes and abstracts high dollar charts, day after discharge, as well as interim charts
• Reviews complex medical documentation at a highly skilled and proficient level from clinicians, qualified health professionals and hospitals to assign diagnosis and procedure codes utilizing ICD CM/PCS, CPT, and HCPCS
• Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software
• Assigns codes for present on admission, research, Hospital acquired Conditions and Core Measure Indicators for all diagnoses both concurrently and post-discharge
• Collaborates with other departments to clarify pre-bill coding documentation issues such for inpatient and outpatient to insure reimbursement and clinical outcomes
• Works claim edits for all patient types and may codes consecutive/combined accounts to comply with the 72-hour rule and other account combine scenarios
• Completes informal peer-review on inpatient and outpatient coders
• Tracks and trends quality information from internal and external sources to partner with the educational team on opportunities
• Communicates with Medical Staff, CDI, Post -bill for documentation clarification
• Utilizes EMR communication tools to track missing documentation on inpatient queries that require follow-up to facilitate coding in a timely fashion
• Partners with HIM, Patient Accounts, and Integrity, when needed, to help resolve issues affecting reimbursement and outcomes
• Maintains current knowledge of changes in Inpatient coding and reimbursement guidelines and regulations as well as new applications or settings for coding all types of patients
• Must be able to use critical decision-making skills to determine when to query to clarify documentation independently for outcomes, reimbursement and benchmarking
Requirements:
• Two Year associate degree or equivalent work experience
• Five to Seven years of inpatient coding experience in an acute care inpatient setting in an Academic Inpatient Care Tertiary Facility
• Advanced proficiency of ICD, CPT and HCPCS coding guidelines
• Advanced knowledge of medical terminology, anatomy and physiology
• Excellent computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications
• Excellent organization, prioritization, and reading comprehension skills
• Excellent analytical skills, with a high attention to detail
• Ability to work independently and exercise independent judgment and decision making
• Ability to meet deadlines while working in a fast-paced environment
• Ability to take initiative and work collaboratively with others
Benefits:
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program
Apply Now
Apply Now