This position is responsible for reviewing clinical documentation and assigning ICD-10-CM diagnosis, PCS procedure codes, and the DRG to ensure proper reimbursement for complex inpatient accounts. Requires extensive knowledge and understanding of ICD-10-CM/PCS coding guidelines, MS-DRG and APR-DRG reimbursement systems, medical terminology, and disease processes. Works closely with Clinical Documentation Integrity and clinicians to ensure complete and accurate documentation, coding, and final DRG assignment. Adheres to the quality and productivity standards set by the department.
Key Responsibilities:
- Evaluates health record documentation and accurate reimbursement by ensuring that ICD-10-CM diagnostic and PCS procedural codes accurately reflect and support the inpatient hospital admission
- Identifies documentation clarification opportunities to ensure that documentation supports the coding and DRG assignment. Initiates coding queries and provides feedback to clinicians
- Reviews Local Coverage Determination (LCD)/National Coverage Determination (NCD) policies for ICD-10-CM diagnoses that support medical necessity for services provided
- Works with the coding denials team for education and assists with DRG denial prevention solutions
- Ensures inpatient accounts are coded accurately and in a timely manner
- Consistently maintains coding quality (95% accuracy) and productivity expectations
- Assists with the training of inpatient coders
Educational Requirements:
- Successful completion of a coding program, including coursework in ICD-10-CM/PCS, medical terminology, anatomy and physiology, and disease processes
Required Qualifications:
- Two (2) years of hospital inpatient/DRG coding experience
- Passing score on the Essentia Health senior inpatient coding skills assessment
Preferred Qualifications:
- Epic experience
- 3M Encoder experience
- Computer Assisted Coding experience
Licensure/Certification Requirements:
- Current certification with AHIMA or AAPC and credentialed as RHIA, RHIT, CPC, CCS, and/or CIC
Employee Benefits: Essentia Health supports well-being, growth, and work-life balance including medical, dental, vision, life, and disability insurance; 401(k) with employer contributions; professional development through training and tuition reimbursement; flexible scheduling; generous time off; and wellness resources. Benefit eligibility may vary.
- Completion of coding program with coursework in ICD-10-CM/PCS, medical terminology, anatomy, physiology, and disease processes
- Minimum two years of hospital inpatient/DRG coding experience
- Certification as RHIA, RHIT, CPC, CCS, CIC or equivalent
- Passing Essentia Health senior inpatient coding skills assessment
- Preferred: Epic, 3M Encoder, and Computer Assisted Coding experience
- Medical, dental, vision, life, and disability insurance
- 401(k) plan with employer contributions
- Training, tuition reimbursement, and educational programs
- Flexible scheduling and generous time off
- Wellness resources for physical, mental, and emotional health
Location
Minnesota, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
3 weeks ago