Coder 2, Per Diem
Beth Israel Deaconess Medical Center
- Charlestown, MA
- Permanent
- Part-time
2. Selects and sequences principal, secondary, and procedure based on provider medical record information to ensure accurate DRG assignment and reimbursement.
3. Assigns applicable ICD-10 Codes, Present on Admission (POA), Hospital Acquired Condition (HAC), and Patient Safety Indicators (PSI) codes using current industry guidelines from (but not limited to), AHIMA, Coding Clinic, CMS, specific payers, Agency for Healthcare Quality and Research (AHRQ) and CDC (official coding guidelines).
4. Utilizes grouper software to assist with assignment of accurate codes and to calculate appropriate DRG for hospital reimbursement.
Applies a thorough knowledge of medical terminology, anatomy & physiology and coding systems to accurately assign diagnoses and procedures in accordance with department, hospital, and regulatory requirements.
5. Submits queries to providers as needed when a diagnosis or procedure has been determined to meet the guidelines for reporting but has not been clearly or completely stated within the medical record, when ambiguous or conflicting documentation is present, or when documentation is unclear for POA indicator assignment.
6. Acts as a resource to representatives from Patient Financial Services as needed to provide accurate coding/billing data and expedite the billing process.
7. Demonstrates efficiency in use of hospital information system by abstracting all information, codes and charges appropriately, including 3M, Epic, and Cobius.
8. Communicate issues with incorrect documentation and software inability to complete functions to Manager or Supervisor of Hospital Coding as needed.
9. Reviews denials in Cobius Denial Software and determine appropriate resolution based on audit.
10. Works with Clinical Decision Specialists regarding MD Queries and correlation of care.
11. Receives accounts from DRG Validator and adjusts accordingly for optimization of accountAdditional Level II Responsibilities1. Codes high dollars and long lengths of stay.
2. Mentors New Coding staff and provides continuous communication and instruction with colleagues.Minimum Qualifications:Education:
- Minimum High School degree or equivalent; college degree highly desirable.
- CCS, CCS-P, CPC, CPC-H
- Minimum five years of hospital inpatient coding experience and/or an RN or other healthcare clinician with at least 5 years acute care experience (e.g., medical-surgical, ICU, case management, etc.).
- Knowledge of Medical Terminology, Anatomy & Physiology, and coding clinical concepts such as gained from coding coursework.
- Knowledge of payment methodologies including prospective payment (PPS), federal and state regulations.
- Computer skills, including knowledge of Microsoft Office and encoder.
- Ability to work in a high paced, high volume, multi-task environment.
- Strong organization and communication skills.