Inpatient Coder III

Must reside in AL, AZ, CO, CT, DE, FL, GA, IL, IN, KS, MA, MD, ME, MI, MS, NC, NH, NJ, NY, OH, PA, SC, TN, TX, VA.

At Nuvance Health, we enjoy the benefits of a two-state system as we cultivate an inclusive culture where everyone feels welcomed, respected and supported. Together, we are a team of 15,000+ strong hearts and open minds. If you share our values of connected, personal, agile and imaginative, we invite you to discover what’s possible for you and your career.

Summary: Appropriately analyzes and codes complex inpatient records. Position requires high-level expertise in coding and documentation guidelines, coding clinics and knowledge of MS DRGs, CC/MCC for appropriate reimbursement and compliance. Acts as a recognized subject-matter expert, leading DRG validation, revenue integrity analyses, and strategic coding compliance projects across the department.

Responsibilities:

• Performs ICD-10-CM diagnostic and ICD-10 PCS procedural coding to maintain an accurate database & ensure accurate coding at minimum accuracy rate of 95%.
• Competent in the utilization of an electronic medical record, and computerized coding/abstracting systems.
• Applies knowledge of diagnosis related group assignment, official Coding guidelines, comorbidity/complication coding, Hospital acquired conditions, accurate present on admission assignment, and current American Hospital Association coding clinic guidance.
• Effectively and professionally communicates with providers and/or CDI staff when necessary to clarify documentation to assign accurate diagnoses and procedures to calculate the appropriate diagnosis related group and severity of illness/risk of mortality.
• Ability to code using either 3M encoder or ICD-10-CM/ICD10 PCS codebook.
• Mentors and trains junior coders.
• Performs audits as assigned by the coding manager.
• Demonstrates advanced knowledge of the impact of coding decisions on revenue cycle, including the ability to assist in appealing payer denials.
• Responds to business office questions regarding diagnoses and procedures timely.
• May assist as needed in other coding areas.
• Attends required hospital education programs to maintain and enhance coding skills and stay abreast of changes in codes, guidelines, and regulations.
• Maintains certified coding credentials and demonstrates annual compliance.
• Fulfills all compliance responsibilities related to the position.
• Maintains and models the organization's values.
• Demonstrates regular, reliable, and predictable attendance.
• Performs other duties as assigned.

Requirements:

• Certified Coding Specialist (AHIMA), or Certified Inpatient Coder (AAPC).
• Specialized training in medical terminology, ICD-10-CM/ICD-10 PCS coding.
• Ability to decipher operative reports, medication orders & various medical records for appropriate code selection.
• Experience in acute care coding inpatient records, minimum five years demonstrated coding experience.
• Desired coursework: Anatomy and Physiology and knowledge of CPT codes.
• Education: High School Graduate or Equivalent.

Working Conditions:

• Manual: Little or no manual skills/motor coordination & finger dexterity.
• Occupational: Little or no potential for occupational risk.
• Physical Effort: Sedentary/light effort, may exert up to 10 lbs.
• Physical Environment: Generally pleasant working conditions.