Inpatient Coder II, HB Coding

The Inpatient Coder II is responsible for assigning ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes for complex inpatient acute care discharges. This role serves as a coding and reimbursement expert, supporting accurate reimbursement, quality metrics, and reporting.

Responsibilities include:

• Assign appropriate ICD-10-CM and ICD-10-PCS codes for complex inpatient visit types
• Assign Present on Admission (POA) values for secondary diagnoses
• Review provider notes and Clinical Documentation Improvement (CDI) findings
• Use CAC (Computerized Assisted Coding) software to review documentation and assign codes
• Validate and correct discharge disposition documentation that affects reimbursement
• Apply knowledge of MS-DRGs, APR-DRGs, and risk adjustment methods to sequence diagnoses accurately
• Collaborate with CDI on discharge reviews and final DRG determinations
• Educate CDI staff on regulatory guidelines, Coding Clinics, and coding conventions
• Interpret health record documentation to determine principal and secondary diagnoses and procedures
• Write appeal letters in response to payor DRG downgrade notices
• Resolve nosology messages, alerts, and coding validation errors
• Maintain established coding productivity and quality standards