Coder – Inpatient

This is a fully remote position, open to applicants in New York.

📋 Description

• Assess clinical documentation and diagnostic findings to extract necessary data and apply the correct ICD-10-CM and ICD-10-PCS codes for billing, internal and external reporting, research, and regulatory compliance.

• Exhibit knowledge of reimbursement methodologies and implement these to the assigned charts to enhance reimbursement and/or address regulatory edits.

• Address error reports related to the billing process, identify and report error trends, and, when needed, contribute to the design and execution of workflow modifications to minimize billing errors.

• Comply with the Standards of Ethical Coding established by the American Health Information Management Association (AHIMA), follow official coding guidelines, and stay updated on coding revisions and interpretations.

• Adhere to RRH & HIM department policies and procedures.

• Conduct a thorough review of inpatient record documentation to identify and allocate diagnosis and procedure codes utilizing ICD-10-CM and ICD-10-PCS.

• Consistently meet departmental productivity standards with 95% accuracy.

• Proficiently use Care Connect, UDS, and Clintegrity systems to retrieve ICD-10 codes and DRG assignments.

• Create compliant Physician Coding Queries when documentation is insufficient, ambiguous, or unclear for coding purposes.

• Accurately enter and/or update data including Present on Admission (POA) indicators, Point of Origin, Discharge Disposition, and other relevant data.

• Handle problematic workflow edits and other technical issues to ensure prompt resolution regarding coding A/R days.

• Rectify failed claim errors related to billing edits, misclassified accounts, and other discrepancies identified through various auditing processes in a timely manner.

• Participate in RGHS, HIM Department, and Coding Team meetings and training sessions as needed.

• Ensure timely reporting in compliance with external regulations.

• Perform additional duties as assigned by HIM leadership.

• Provide support to customers (physicians, clinical quality staff) concerning clinical documentation opportunities, coding reimbursement matters, and quality improvement review processes.

⛳️ Requirements

• One of the following certifications is mandatory: Applicable advanced coding certification credential includes: Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder Hospital Based (CPC-H), Certified Medical Coder (CMC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder Apprentice (CPC-A), or a specialty coding certification.

• Candidates with an Associate degree from an accredited institution of the American Health Information Management Association (AHIMA) must sit for the Registered Health Information Technician (RHIT) exam within one year of hire.

• A minimum of 2 years of progressive coding experience in a hospital or multi-specialty physician practice setting is preferred.

• For HOMECARE: Homecare Diagnosis Coding Specialist (HCS-D) certification is required within 16 months of hire. Grandfather Clause: If hired on or before September 30, 2018, 2 years of relevant work experience and one of the following coding certification credentials: Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder - Hospital Based (CPC-H), Certified Medical Coder (CMC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or a specialty coding certification and an Associate’s degree in Health Information Management are required.

🏝️ Benefits

• Comprehensive health insurance options.

• Retirement savings plan with employer match.

• Opportunities for professional development and continuing education.

• Flexible work schedules and work-from-home options.