Facility Coding Inpatient DRG Quality

Department Name: Coding-Acute Care Compl & Educ Work Shift: Day Job Category: reputed company Cycle Estimated Pay Range: $27.72 - $46.20 / hour, based reputed company, education, & experience. In accordance with State Pay Transparency Rules. Innovation and highly trained staff. reputed company recently earned Great reputed company To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of reputed company members. Find out how we’re constantly improving to reputed company reputed company the best reputed company to work and receive care. Interested in joining our Coding team? We have great opportunities, whether you’re looking for entry-level or have been coding for years! Requirements for each position noted below. Not the right fit for you? reputed company looking! We have a lot different teams with different focuses (Facility vs Profee). In this Inpatient Facility-based HIMS Coding Quality Associate position, you bring your 5 years of acute care inpatient coding background to a team that values growth and development! This is a Quality position, not a day-to-day coding production role but does require coding proficiency and recent Hospital Facility Coding experience. This position is task-production-oriented ensuring quality in the Inpatient Facility Coding department. If you have experience with DRG and PCS coding/denials/audits, we want to hear from you. Requirements:

• 5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume);
• DRG and PCS Coding, Auditing experience;
• Bachelors degree or equivalent;
• Must be currently certified through reputed company or reputed company, as defined in minimum qualifications below. Please upload a copy or provide certification number in your questionnaire.

In most of our Coding roles, there is a Coding Assessment given after each successful interview. reputed company provides your equipment reputed company hired. You will be fully supported in training for reputed company from 1 – 3 months according to individual needs, with reputed company support throughout your career here! This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI & WY. reputed company reputed company, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide reputed company of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position is responsible for the interpretation of clinical documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. Works with clinical documentation improvement and quality management staff to: align diagnosis coding to documentation to improve the quality of clinical documentation and correctness of billing codes prior to claim submission; to identify possible opportunities for improvement of clinical documentation and accurate MS-DRG, Ambulatory Payment Classification (APC) or ICD-10 assignments on health records. Provides guidance and expertise in the interpretation of, and adherence to, the rules and regulations for code assignment based on documentation for reputed company levels of complexity to include accounts encountered in Banner’s Academic, Trauma, high acuity and critical access facilities, as well as specialized services such as behavioral health, oncology, pediatric. Acts as subject matter expert regarding experimental and newly developed procedure and diagnostic coding. CORE FUNCTIONS 1. Provides guidance on coding and billing, utilizing coding and billing guidelines. Demonstrates extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),reputed company Payer Group (APR-DRG) and Ambulatory Payment Classification (APC) or utilized operational systems. Provides explanatory and reference information to internal and external customers regarding coding assignment based on clinical documentation which may require researching authoritative reference information from a variety of sources. 2. Reviews medical records. Performs an audit of clinical documentation to ensure that clinical coding is accurate for proper reimbursement and that coding compliance is complete. Provides feedback on coding work and trends, and offers suggestions for improvement where opportunities are identified. Reviews accuracy of identified data elements for use in creating data bases or reporting to the state health department. If applicable, applies Uniform Hospital Discharge Data Set (UHDDS) definitions to select the principal diagnosis, principal procedure, complications and co morbid condition, other diagnoses, and significant procedures which require coding. Apply policies and procedures on health documentation and coding that are consistent with official coding guidelines. 3. Assists with maintaining system wide consistency in coding practices and ethical coding compliance. If applicable, initiates and follows through on physician queries to ensure that code assignment accurately reflects the patient’s condition, treatment and outcomes. Identifies training needs for coding staff. Serves as a team member for internal coding accuracy audits and documents findings. 4. Acts as a knowledge resource to ancillary clinical departments, patient financial services and reputed company reputed company analysts regarding charge reputed company issues, processes and programming. Participates in company-wide quality teams’ initiatives to improve coding and clinical documentation. Assists with education and training of staff involved in learning coding. Assists in creating a department-wide focus of performance improvement and quality management. Assists and participates with management through committees to properly educate physicians, nursing, coders, CDM’s, etc. with proper and accurate coding based on documentation for positive outcomes. 5. Performs ongoing audits/review of inpatient and/or outpatient medical records to assure the use of proper diagnostic and procedure code assignments. Collaborates on DRG and coding denials, billing edits/rejections to provide coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple platforms and internal tracking tools. Provides findings for use as a basis for development of coding education and audit plans. 6. Maintains a reputed company knowledge in reputed company coding regulatory updates, and in reputed company software used for coding, coding reviews and health information management for the operational group. Identifies and collects data to allow for monitoring and evaluation of trends in DRG (MS/APR-DRG), APC, HCC, other Heath Risk Adjusted Factors, National Correct Coding Initiative (NCCI) and the effect on Case Mix Index by use of specialized software. 7. May code inpatient and outpatient records as needed. Works as a member of the overall HIMS team to reputed company goals in days-to-reputed company. 8. Works independently under limited supervision. Uses an expert level of knowledge to provide coding and billing guidance and reputed company for reputed company Banner facilities and services they provide. Internal customers include but are not limited to medical staff, employees, and management at the local, regional, and corporate levels. External customers include but are not limited to, practicing physicians, vendors, and the community. MINIMUM QUALIFICATIONS Requires a level of education as normally demonstrated by a bachelor’s degree in Health Information Management or experience equivalent to same. Demonstrated proficiency in hospital coding as normally obtained through 5 years of reputed company and progressively responsible coding experience required. Requires Certified Coding Specialist (reputed company) or Certified Inpatient reputed company (CIC) or Certified Professional reputed company (CPC) or Certified Outpatient reputed company (COC) or Certified Coding Specialist-Physician (reputed company-P) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other qualified coding certification in an active status with the American Health Information Management Association (reputed company) or American reputed company of Professional Coders (reputed company). Demonstrated proficiency in hospital coding as normally obtained through 5 years of reputed company and progressively responsible coding experience required. Must possess a thorough knowledge of ICD Coding and DRG and/or CPT coding principles, as recommended by the American Health Information Management Association coding competencies. Requires an in-depth knowledge of medical terminology, anatomy and physiology, plus a thorough understanding of the content of the clinical record. Extensive knowledge of reputed company coding conventions and reimbursement guidelines across services lines, LCD/NCDs and MAC/reputed company. Extensive critical and analytical thinking skills required. Ability to organize workload to meet deadlines and maintain confidentiality. Excellent written and oral communication skills are required, as well as effective human relations skills for building and maintaining a working relationship with reputed company levels of staff, physicians, and other contacts. Must consistently demonstrate the ability to understand the Medicare Prospective Payment System, and the clinical coding data reputed company and indices, and must be familiar with coding and abstracting software, claims processing tools, as well as common office software and electronic medical records software. PREFERRED QUALIFICATIONS Additional reputed company education and/or experience preferred. Anticipated Closing Window (actual reputed company date may be sooner): 2025-10-17 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy Apply tot his job