CODER III

Job Summary:

Performs final, ICD-10-CM diagnosis coding and ICD-10-PCS on Inpatient Encounters. Responsible for capturing MCC, CC and all secondary diagnosis with assignment of the correct DRG based on documentation. Inpatient coders help insure the data integrity of the patient's clinical record. Inpatient coders must be able to assign present on admission indicators appropriately. Inpatient coders are responsible for the abstraction of ADT information at the time of final coding. Inpatient Coders must be able to effectively communicate with the medical staff, other departments, and teammates through queries, email, telephone, teleconference and/or face to face encounters. Coders are expected to research diagnosis and procedure techniques to ensure assignment of the appropriate ICD10 CM and ICD10 PCS codes. Uses EPIC and 3M software to review the electronic medical record and the 3M encoder to code and calculate the billing DRG and assign POA indicators. Inpatient coders are to understand the impact coding makes on quality reporting and have working knowledge of CMS quality programs. Inpatient coders are expected to work cooperatively with other team members. Performs clerical duties as required or as designated by the Director, Manager or Supervisor.

Performance Expectations:

• Exceptional oral and written skills are required to relate effectively to hospital staff, physicians, and review agencies.
• Demonstrates ability to code records according to set productivity standards.
• Demonstrates the ability to work edits received from patient accounts.
• Demonstrates the ability to abstract (i.e., correct codes, dates, provider information, and discharge status) all records within 4 days of patient discharge to ensure timely reimbursement.
• Demonstrates the ability to maintain performance standards set by the department.

Qualifications:

Education/Skills:

Associate degree in a medical related field is preferred. Completion of a certified coding program is

required or 2 yrs coding experience required.

Work Experience:

Three years experience in ICD-10-CM, ICD-10-PCS in an acute care hospital is preferred. Must have a

working knowledge of Health Information Management and experience with various computer software

environments.

Mental Demands:

Must be able to use the ICD 10 Official Coding Guidelines and other coding resources available . Ability to type and be familiar with the rules of spelling, grammar, and punctuation. Must have the ability to use a computer, copier, telephone, printer, and fax. Knowledge of DNV standards and other regulatory systems is essential. Must have a high energy level, be comfortable working remote and have a dedicated work ethic