The Inpatient Coder is responsible for accurately assigning diagnostic and procedure codes to inpatient encounters based on documentation in the electronic medical record while maintaining compliance with established rules and regulatory guidelines.
Key responsibilities include:
- Review inpatient medical record documentation and abstract data into coding and EHR systems.
- Assign accurate ICD-10-CM and ICD-10-PCS codes using an electronic encoder.
- Determine principal or final diagnoses, comorbid conditions, complications, secondary conditions, and procedures.
- Initiate physician queries to clarify diagnoses and/or procedures when needed.
- Maintain coding quality, productivity, and timely processing of assigned work items.
- Support organizational AR goals related to uncoded accounts.
- Follow AHIMA ethical coding standards and official coding guidelines.
Requirements & Qualifications
- Associate’s degree or higher in a CAHIIM-accredited program, or an additional two years of experience in lieu of degree.
- One year of relevant inpatient coding experience, or successful completion of the Houston Methodist Coding Apprentice Program or Outpatient to Inpatient Coder Transition Program.
- One of the following certifications required:
- RHIT (AHIMA)
- RHIA (AHIMA)
- CCS (AHIMA)
- Knowledge of coding classification systems, DRG and APC systems, official coding guidelines, and coding compliance.
- Working knowledge of medical terminology, anatomy, and physiology.
- Proficiency with electronic encoder applications preferred.
- Knowledge of electronic medical records and imaging systems preferred.
- Strong computer skills with common office software, coding software, and abstracting systems.
- Ability to communicate effectively with patients, physicians, family members, and coworkers.
Location
Nashville, Tennessee, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago
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