Medical Coder

A Medical Coder at Nexus Health Systems is responsible for accurate coding and DRG assignment for all Nexus facilities under the supervision of the System Director Health Information Management. The role requires maintaining professional certification and knowledge of LTC MS-DRGs, APR-DRGs, ICD-9-CM, ICD-10-CM, and CPT coding requirements. Responsibilities include admission, concurrent, and discharge coding, meeting turnaround times, abstracting, coding query compliance, and collaborating with CDI to improve physician documentation and metrics utilization.

This position is 100% remote but requires travel to the facility for scheduled meetings and mandatory in-services.

Key responsibilities include:

• Timely and accurate coding adhering to Nexus turnaround times, including principal diagnosis assignment within 24 hours of H&P completion, daily concurrent abstraction, and final DRG and code assignment within 72 hours of discharge.
• Abstracting and auditing medical records for documentation compliance and accuracy.
• Identifying and implementing documentation improvement through coding queries.
• Creating and tracking coding query compliance for physicians.
• Participating in weekly DRG multidisciplinary meetings to enhance clinical knowledge and optimize documentation.
• Updating HIM statistics related to admissions, discharges, code assignments, and maintaining daily DRG spreadsheets.
• Maintaining at least 90% accuracy on monthly coding audits.
• Assisting with RAC and third-party audit reviews.
• Problem-solving to minimize delays in coding or clinical care.
• Self-educating on federal, state, and accreditation coding guidelines and utilizing coding clinics.
• Completing all 3M education coding modules for ICD-10.
• Collaborating with facility administration, case management, and liaisons on coding changes and documentation barriers.
• Attending coding roundtables, meetings, and assigned in-services.

Qualifications:

• Preferred completion of a 2 or 4-year accredited Health Information Management degree.
• Minimum 4 years of inpatient ICD-9-CM, PCS, and CPT coding experience, preferably with Long Term Acute Care.
• Knowledge of LTC-MS-DRGs, APR-DRGs, coding query utilization, and documentation improvement practices.
• ICD-10 training completed; dual coding experience preferred.
• RHIA, RHIT, or CCS certification with maintenance. Certification must be maintained during employment or obtained within 30 days of hire.