Job Description

Position Highlights:

The Hospital Inpatient Coder Senior will be expected to apply extensive knowledge in assigning ICD-10- CM diagnosis and ICD-10-PCS procedure codes and Medicare Severity-Diagnosis Related Groupers (MS-DRG) for complex hospital inpatient services. Applies clinical knowledge of disease processes, physiology, pharmacology, and surgical techniques by reviewing and interpreting all clinical documentation included in an inpatient record. Abstracts data in compliance with national and regional policies. Clarifies physician documentation by utilizing a facility-established query process. Demonstrates knowledge of sequencing diagnoses and procedure codes outlined in the ICD-10-CM/ICD-10-PCS Official Coding Guidelines, Uniform Hospital Discharge Data Set, CMS guidelines, and other resources as applicable.

The Hospital Inpatient Coder Senior is expected to function as a subject matter expert on the team and assist less experience team members on following operational policies. It is responsible for training and onboarding new team members and participating in special projects assigned by the Mid Revenue Cycle leadership.

Responsibilities:

• Coding Encounter.
• Key Performance Indicator Requirements.
• Constraints of systems.
• Query Knowledge.
• Team Support.
• Special Projects.
• Perform other duties as assigned.

Credentials and Experience:

• High School Diploma/GED.
• Five (5) years in hospital inpatient coding experience with ICD-10 diagnosis, procedure codes and MSDRG.
• Any (one) of the following certifications is required:
  • CCS) Certified Coding Specialist.
  • (CPC) Certified Professional Coder.
  • (COC) Certified Outpatient Coding.
  • (CCS-P) Certified Coding Specialist - Physician.
  • (RHIT) Registered Health Information Technician.
  • (RHIA) Registered Health Information Administrator.
  • (CIC) Certified Inpatient Coder.
• Any certification not listed above, but issued from a Governing Body listed below, will be considered by the business.
  • AHIMA or AAPC

Minimum Skills/Specialized Training Required:

• Thorough understanding of the effect of data quality on prospective payment, utilization, and reimbursement for multiple medical specialties.
• Experience in coding hospital inpatient electronic medical records.
• Excellent communication and interpersonal skills.
• Experience with automated patient care and coding systems.
• Competence with MS Office software.
• Extensive knowledge of American Healthcare Association ("AHA") coding clinic guidelines, ICD-10-CM and ICD-10-PCS coding guidelines, Medicare Severity Diagnosis Related Groupers ("MSDRG"), All Patient Refined Diagnosis Related Groupers ("APRDRG"), Center for Medicare & Medicaid Services ("CMS") guidelines, National Center for Healthcare Statistics ("NCHS").

Preferred Experience:

• Preferred qualifications include:
  • Experience with coding oncology-related services.

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