Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!Job Title: Hospital Coding Specialist II (Remote)Cost Center: 101651098 System Support-Facility CodingScheduled Weekly Hours: 40Employee Type: RegularWork Shift: 8-hour day shifts, variable days (United States of America)Job Description:JOB SUMMARYHospital Outpatient Coding:The Hospital Coding Specialist ll reviews clinical documentation and diagnostic results as appropriate to extract data and apply appropriate International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes for billing, internal and external reporting, research and regulatory compliance activities. This individual accurately codes outpatient conditions and procedures as documented in the medical record and applying the ICD Official Guidelines for Coding and Reporting. The Hospital Coding Specialist II provides charge validation and capture processes for various patient types. This individual assigns codes for diagnoses, treatment, and procedures according to the appropriate classification system for outpatient encounters. The Hospital Coding Specialist II utilizes technical coding principles and APC reimbursement expertise to assign appropriate ICD diagnoses, ICD CPT/HCPCS codes including modifier assignment. This individual validates and/or identifies chargeable items for various patient types (i.e., OBS, SDS) and enters them into the billing system to include the following outpatient visit types:
Ambulatory surgery (same day surgery), may include charge capture
Observation service encounters
Other hospital outpatient types in accordance with Coder II job descriptions, as assigned
Hospital Inpatient Coding:The Hospital Coding Specialist II accurately codes inpatient conditions and procedures as documented in the International Classification of Diseases (ICD) Official Guidelines for Coding and Reporting and in the Uniform Hospital Discharge Data Set (UHDDS) and assignment of the appropriate MS-DRG (Medicare Severity-Diagnosis Related Group) or APR-DRG (All Patients Refined Diagnosis Related Groups) for complex, multi-specialty inpatient services. This individual understands and applies applicable medical terminology, anatomy and physiology, surgical technology, pharmacology and disease processes. The Hospital Coding Specialist II reviews professional and hospital inpatient medical record documentation and properly identifies and assigns:
ICD CM and PCS codes for all reportable diagnoses and procedures. This includes determining the correct principal diagnosis, co-morbidities and complications, secondary conditions, surgical procedures and/or other procedures.
MS-DRG /APR-DRG
Present on admission indicators
HAC (Hospital Acquired conditions) and when required, report through established procedures
PSI conditions and report through established procedures
Discharge Disposition code
Works collaboratively with the Clinical Documentation Improvement Specialists to address documentation concerns and DRG assignments
Assists in the preparation of responses to DRG validation requests and other third party payer inquiries related to coding and DRG assignments as requested
JOB QUALIFICATIONSEDUCATIONThe individual applying must meet the minimum qualifications in all three required sections below to be considered a candidate for interview. Please consider when listing minimum qualifications.Minimum Required: Medical coding diploma or American Health Information Management Association (AHIMA) approved health information management degree or related program.Preferred/Optional: NoneEXPERIENCEMinimum Required: Two years of coding and reimbursement experience in a multi-specialty setting clinic/hospital, or completion of coding degree or diploma will be considered in addition to the following:
Knowledge of medical terminology, anatomy and physiology, pharmacology, disease process, and surgical procedures
Knowledge of accepted medical abbreviations and their meanings
Knowledge in the use of specialized references such as the ICD and CPT-4 books, medical dictionaries and texts, and medical journals
Must have extensive knowledge of Coding Clinic, CPT Assistant and all official coding guidelines
Advanced knowledge of hospital information systems, encoders and other technology to facilitate a successful work environment while maintaining maximum communication and adhering to HIPAA security standards
Advanced knowledge Microsoft Outlook, Excel and Word functions
Technical skills required to learn and navigate a variety of software systems and trouble shoot computer problems
Strong written and verbal communication skills
Ability to think and work independently, yet interact positively with team
Advanced problem solving skills
Attention to detail is crucial to this position
Preferred/Optional: Experience with electronic health record systems.CERTIFICATIONS/LICENSESThe following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the positionMinimum Required: AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management) credential (i.e. CCS, CCS-P, RHIT, RHIA, CCA, CPC, CPC-H, COC) within one year of hire.Preferred/Optional: AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management) credential (i.e. CCS, CCS-P, RHIT, RHIA, CCA, CPC, CPC-H, COC) at time of hire.Given employment and/or payroll requirements of individual states, Marshfield Clinic Health System supports remote work in the following states:AlabamaArkansasFloridaGeorgiaIdahoIllinois (except Chicago; limitations in other counties)IndianaIowaKansasKentuckyMichiganMinnesota (limitations in some counties)MississippiMissouriNebraskaNorth CarolinaNorth DakotaOklahomaSouth CarolinaSouth DakotaTennesseeTexasUtahWisconsinWyomingMarshfield Clinic Health System will not employ individuals living in states not listed above.Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System’s Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
