Inpatient Coder (Coding Specialist lll)

Department Overview:

This level 3 coding position provides support to the Enterprise Coding Department for the coding of Inpatient services. The Inpatient Coder position requires certification and active credential status with AHIMA and advanced coding experience in the highly specialized areas of Inpatient coding.

• Inpatient Coding Services: This position is responsible for reviewing clinical documentation and assigning the correct ICD 10 CM and ICD 10 PCS coding to Inpatient records.
• Utilizes Epic and Solventum 3M 360 systems.
• Effectively communicates via email.
• Collaborates with Coding Leads, Clinical Documentation Specialists and Billing Dept to ensure correct coding and DRG assignment resulting in accurate Case Mix Index calculations and reimbursement.
• Ensures that the documentation is in compliance with ICD 10 and CMS coding guidelines.
• Advises coding partners and new hires in coding assignments.
• Requires maintaining an hourly productivity standard and quality standards as set by Enterprise Coding and based on Industry Standards.
• Requires attendance of Enterprise Coding and Clinical Department meetings via conference call and WebEx.
• Coding Work queue assignment will vary based on business needs or management assignment.

Function/Duties of Position:

Coding

• Inpatient Coding at 95% or above accuracy.
• Abstract information from inpatient medical records to assign correct codes following the ICD 10 guidelines.
• Identify query opportunities.
• Verify Account Class, Attending provider, and Discharge Disposition in Epic. Assign codes via Solventum 3M 360.
• Resolve with coding leads and billing, any issues, coding denial requests or questions as part of coding denial process.
• Follow team procedures necessary in carrying out ICD 10 coding on cases in the Uncoded IP accounts work queue in Epic.
• Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
• Coordinate all billing information and ensure that all information is complete and accurate. (diagnosis codes/poa indicators/procedure codes/procedure dates/provider info/discharge disposition)
• Ability to maintain supportive and open communication with coding supervisor and team leads regarding coding issues and priority coding responsibilities assigned.

Department support:

• Serve as a resource to inpatient coding leadership and coding team for a broad range of billing policy and procedure issues.
• Attends coding meetings and seminars and shares knowledge with other coders.
• In collaboration with Leadership, make recommendations and implement remedial actions for problems.
• Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and government agencies to advise physicians of billing practice changes in ICD-10.
• Participate in Enterprise Coding education sessions, Kaizen events, maintain CEUs, stay informed of current trends in coding.

Required Qualifications:

• High school diploma or GED
• Minimum of 4 years professional or hospital (depending on position) experience reviewing, abstracting, coding in ICD 10 CM or ICD 10 PCS, or CPT
• Certification in one of the following (as indicated by the position description) Coding certification from AAPC or AHIMA:
  • Registered Health Information Administrator (RHIA),
  • Registered Health Information Technician (RHIT),
  • Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA). 
  • Active AHIMA membership may be required for some positions.
  • Certified Professional Coder (CPC) through the American Academy of Professional Coders; OR equivalent certification. 

Preferred Qualifications:

• Accredited Coding Program, Associates or Bachelor Degree; Specialized Coding Credential
• Knowledge of Inpatient coding guidelines, MCE and compliance edits
• Experience using an EMR.
• Experience using EPIC, 3M encoder. 
• Proficiency with word processing and Excel spreadsheets.
• Advanced knowledge of ICD-10-CM, Federal Register, Federal and State insurance billing laws and Mandates. 
• Excellent verbal and written communication skills with the ability to effectively communicate with individuals at all levels, physicians, nurses, administrative management, etc.
• AHIMA certification required upon hire.
• Able to pass internal coding test to qualify as a Level 3

Additional Details:

• Days of work are Monday through Friday. Weekend work is performed when the Inpt Coder is making up time or working overtime. Once the Monday through Friday schedule is set, it must be adhered to.
• This position is a telecommuting position.

All are welcome: Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.