Utilizes technical coding expertise to assign appropriate ICD10CM and ICD10PCS codes to complex inpatient visit types. Complexity is measured by a Case Mix Index (CMI) and Coder IIs typically see average CMIs of 2.2609. This index score demonstrates higher patient complexity and acuity.
Utilizes expertise in clinical disease process and documentation to assign Present on Admission (POA) values to all secondary diagnoses for quality metrics and reporting.
Thoroughly reviews the provider notes within the health record and the Findings from the Clinical Documentation Nurse in the Clinical Documentation Improvement (CDI) Department who concurrently reviewed the record and provide their clinical insight on the diagnoses.
Utilizes resources within 3M 360 CAC (Computerized Assisted Coding) software to efficiently review documentation and select or assign ICD10CM/PCS codes using autosuggestion or annotation features.
Reviews Discharge Planning and nursing documentation to validate and correct when necessary the Discharge Disposition which impacts reimbursement under Medicares Post Acute Transfer Policy.
Utilizes knowledge of MSDRGs APRDRGs AHRQ Elixhauser risk adjustment to sequence the appropriate ICD10CM codes within the top 24 fields to ensure correct reimbursement.
Collaborate with CDI on approximately 45% of discharges regarding the final MS or APR DRG and comorbidity diagnoses.
Educates CDI on regulatory guidelines Coding Clinics and conventions to report appropriate ICD10CM diagnoses.
Interprets health record documentation using knowledge of anatomy physiology clinical disease process pharmacology medical terminology to determine the Principal Diagnosis secondary diagnoses and procedures.
Follows the ICD10CM Official Guidelines for Coding and Reporting ICD10PCS Official Guidelines for Coding and Reporting Coding Clinic for ICD10CM and ICD10PCS coding conventions and instructional notes to assign the appropriate diagnoses and procedures.
Utilizes coding expertise and knowledge to write appeal letters in response to payor DRG downgrade notices.
Resolves Nosology Messages/Alerts and Coding Validation Warning/Errors.
Meets established coding productivity and quality standards.
EPIC or Cerner Experience preferred. 3M 360 CAC experience required
Position Requirements:
A minimum of three years experience is required in an Academic Medical Center with Inpatient Coding experience.
Current CCS CIC RHIA or RHIT certification
Position requires excellent computer/communication skills for provider and staff interactions.
Candidate must have ability to handle multiple projects and appropriately prioritize tasks to meet deadlines.
Candidate must have excellent organizational skills able to understand and follow individual client Standard Operating Procedures
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