Inpatient Coder

Overview

• Provide expertise in coding rules and guidelines to ensure compliance with industry standards and regulations.
• Interpret and apply National Uniform Billing Compliance rules to support claims payment and provider reimbursement.
• Conduct health data analytics to inform reimbursement business and policy decisions.
• Recommend clinical classification and reimbursement guidelines and standards for provider contracts.
• Perform audits and reviews of medical records to ensure coding accuracy and compliance.
• Develop and coordinate educational programs on coding and documentation for staff and providers.
• Adapt to changing department demands to enhance efficiency and compliance.
• Collaborate with Quality and other departments to validate external reporting accuracy.

Key Responsibilities & Duties

• Verify accurate assignment of diagnoses and procedures within medical records.
• Monitor regulatory updates and implement changes to ensure compliance.
• Conduct audits and reviews for coding accuracy and compliance.
• Address claim denials and rejections, recommending corrective action plans.
• Implement policy and procedural changes to improve coding quality.
• Provide statistical reports and audits on health information management compliance issues.
• Develop training programs on coding and documentation for staff and providers.
• Assist with ICD-10-CM and ICD-10-PCS coding for various departments.

Job Requirements

• Bachelor of Science degree required; Associate's degree preferred.
• Certified Coding Specialist (CCS) certification is mandatory.
• Minimum of 5 years of inpatient coding experience required.
• Proficiency with encoder and EMR computer systems.
• Strong organizational, interpersonal, verbal, and written communication skills.
• Knowledge of denials management and coding compliance preferred.
• Ability to manage multiple projects in a fast-paced environment.
• Experience in developing and implementing coding policies and procedures.