Coder lll -Inpatient Coder

Join to apply for the Coder lll - Inpatient Coder role at Insight Health Systems
. 3 weeks ago. Be among the first 25 applicants.

This range is provided by Insight Health Systems. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$31.00/hr - $36.00/hr

At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full‑service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world‑class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients.

Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE! If you would like to be a part of our future team, please apply now!

These duties are to be performed in a highly confidential manner, following the mission, values, and behaviors of Insight Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers, and guests.

Provides high level technical competency and subject matter expertise analyzing physician/provider documentation contained in assigned Complex Outpatient (CO) and/or Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Provides appropriate Medical Severity Diagnostic Related Groups (MS‑DRG), Present on Admission (POA), Severity of Illness (SOI) & Risk of Mortality (ROM) assignments for Inpatient records and accurate APC assignments and all required modifiers for Complex Outpatient records.

Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD‑CM) diagnosis and procedure codes, Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes, MS‑DRG, POA, SOI & ROM assignments and assignment of APC’s and all required modifiers.

• Knows, understands, incorporates, and demonstrates the Insight Hospital Mission, Vision, and Values in behaviors, practices, and decisions.
• Adheres to Insight Health confidentiality requirements as they relate to the release of any individual or aggregate patient information.
• Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS‑DRGs and APCs.
• Codes Complex Outpatient or Inpatient utilizing encoder software and online tools and references, in the assignment of ICD, CPT, HCPCS codes, MS‑DRG, POA, SOI & ROM assignments, APC assignment and all required modifiers.
• Consults reference materials to facilitate code assignment.
• Understands appropriate link of diagnosis to procedure.
• Appends modifier(s) to procedure code or service when applicable.
• Collaborates with HIM and Patient Financial Services in resolving billing and utilization issues affecting reimbursement.
• Interprets bundling and unbundling guidelines (NCCI).
• Interprets LCDs/NCDs and payer policies.
• Tracks issues (e.g., missing documentation, charges or Inpatient queries that require follow‑up to facilitate coding in a timely fashion).
• Investigates claims denials and/or appeals as directed.
• Consistently meets or exceeds coding quality and productivity standards.
• Maintains up‑to‑date knowledge of changes in coding and reimbursement guidelines and regulations.
• Identifies concerns and resolves moderate to complex problems; notifies appropriate leadership when necessary.
• Performs other duties as assigned by Leadership.
• Maintains a working knowledge of applicable coding and reimbursement Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, and…