Inpatient Coder

SEEKING FOR REMOTE INPATIENT CODER!

Not hiring out of CA, DC, MN, CO, HI, NJ, CT, IL, NV, DE, MA, or NY.

Performs technical and administrative work reviewing, abstracting and assigning accepted medical codes for inpatient (Hospital Billing -Health Information Management) diagnoses, procedures and services. Duties are performed in compliance with third party, state and federal regulations according to standardized procedures.

Description of Job Responsibilities :

• Assigns International Classification of Diseases 10-CM diagnostic and ICD-10-PCS procedural codes accurately and productively and other applicable codes such as MS-DRG on inpatient cases for all entities within the Health Care system including Academic Medical Center cases.
• Groups codes and completed product into payment group.
• Assigns codes that affect Severity of Illness and Risk of Mortality and Hierarchal Condition Categories (HCCs).
• Participates in DRG Reconciliation with Clinical Documentation Specialist (CDS).
• Queries providers when documentation is conflicting, needs clarification and specificity.
• Analyzes information for optimal and proper reimbursement.
• Ensures compliance with all appropriate coding, billing and data collection regulations and procedures.
• Provides information to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines.
• Reviews, analyzes and abstracts physician / other documentation for diagnoses, procedures, discharge disposition and other services provided.
• Obtains missing information and / or to clarifies existing information.
• Accepts feedback from PWC Smart reviews and makes edits as needed to avoid future errors.
• Reviews and processes PWC SMART edits.
• Researches appropriate databases for validation of information.
• Utilizes a variety of software (e.g. Epic, Optum CAC, MS Office, etc.) to compile and validate medical information.

QUALIFICATIONS :