Inpatient Pediatric Medical Coder

This is a fully remote position, open to applicants in United States.

📋 Description

• Analyze clinical documentation and diagnostic findings to extract necessary data and apply ICD-10 and CPT diagnosis codes.

• Code inpatient pediatric cases, encompassing Medicare/NonMedicare, surgical, medical, cardiac, mothers/babies, and trauma scenarios.

• Assign codes to documented services and diagnoses in accordance with ICD-10-CM Official Guidelines, CMS requirements, and mandated standard code sets.

• Request appropriate documentation when services or diagnoses are incomplete or unclear.

• Achieve a coding accuracy rate of 95% while maintaining an average productivity of coding 2 inpatient charts per hour.

• Manage pending queues and GuideAudit review queues on a daily basis.

• Inquire with physicians regarding any conflicting, ambiguous, or incomplete medical record information.

• Adhere to facility query policies and CDI reconciliation processes.

• Identify and communicate charts that require re-billing every day.

• Immediately report any coder downtime.

• Collaborate with IQC staff to uphold facility quality standards.

• Address physician and hospital coding or billing inquiries within eight hours.

• Code or pend every queued chart within a 24-hour timeframe.

• Communicate any coding discrepancies and issues to supervisors.

• Log in and out of ADP and record billing hours in PeopleSoft.

• Work with client and Guidehouse IT departments to resolve any system-related issues.

• Review and refresh Client Portal information for daily coding and abstraction activities.

• Check email at least once every two hours during working hours.

• Complete Guidehouse continuing education and submit relevant certificates.

• Maintain HIPAA-compliant workstations and ensure patient privacy.

• Comply with client and Guidehouse policies and procedures.

⛳️ Requirements

• High School Diploma/GED or equivalent qualification.

• A minimum of 5 years of experience in ICD-10-CM and ICD-10 PCS inpatient coding.

• At least 1 year of experience in pediatric inpatient coding.

• Must possess one of the following credentials: RHIA, RHIT, CCS, CIC, or CPC.

• Proficient understanding of ICD-10 PCS, governmental regulations, official coding guidelines, and third-party documentation and billing standards.

• Capability to maintain a coding accuracy of 95%.

• Must keep professional credentials up to date.

• Familiarity with Coding Clinic Guidelines.

• Compliance with HIPAA regulations regarding workstation and patient privacy.

• Epic experience is a plus.

🏝️ Benefits

• Medical, Rx, Dental & Vision Insurance.

• Personal and Family Sick Time & Company Paid Holidays.

• Position may qualify for a discretionary variable incentive bonus.

• Parental Leave.

• 401(k) Retirement Plan.

• Basic Life & Supplemental Life Insurance.

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts.

• Short-Term & Long-Term Disability Coverage.

• Tuition Reimbursement, Personal Development & Learning Opportunities.

• Skills Development & Certification Programs.

• Employee Referral Program.

• Corporate Sponsored Events & Community Outreach Activities.

• Emergency Back-Up Childcare Program.

• Flexible benefits package.