Experienced Inpatient Medical Record Coder

Position Summary
At Stony Brook Medicine, the

Position Summary
At Stony Brook Medicine, the Coder will be responsible for selecting and assigning accurate codes from the current version of coding systems including ICD-10 CM, ICD-10 PCS, CPT and HCPCS codes.

• Demonstrates proficiency with Microsoft Office Applications, Citrix and Adobe Reader in using required computer systems with minimal assistance.
• Reviews the medical record and all applicable documentation to determine the appropriate codes to assign for the services and diagnoses.
• Utilizes coding resources along with any other applicable reference material available to ensure accuracy in coding for all of the assigned services.
• Follows all HIPAA regulations and upholds a higher standard around privacy requirements.
• Demonstrates the technical competence to use the facility encoder as it interfaces with the hospital mainframe and/or EMR in a remote setting.
• Demonstrates proficiency with Microsoft Office Applications in using required computer systems with minimal assistance.
• Maintains a working knowledge of various laws, regulations and industry guidance that impact compliant coding.
• Must meet all coder productivity and quality goals.
• Ensures the confidentiality of data contained in the medical records as outlined in institutional policies and procedures. Supports and promotes the HIM department by participating in special projects.
• Assigns and sequences ICD-10CM-PCS diagnostic and procedural codes for designated service lines. Working knowledge of MS-DRG and NYS APR DRG grouping logic to accurately reflect the diagnosis, procedures documented in the medical record. Documentation assessment and review for accurate abstracting of clinical data to meet regulatory and compliance requirements.
• Other duties as assigned.

• Associate’s degree, at least 5 years of facility inpatient coding experience and CCS certification OR, in lieu of a degree,
• At least 8 years of facility inpatient coding experience and CCS certification OR
• At least 10 years of facility inpatient coding experience

• Bachelor’s degree in a non-clinical Healthcare related field such as HIM, Health Sciences, Health Informatics or related field
• 10 or more years facility inpatient coding experience
• Experience coding facility inpatient encounters for an academic medical center

This position will remain posted until filled or for a maximum of 90 days. An initial review of all applicants will occur two weeks from the posting date. Candidates are advised on the application that for full consideration, applications must be received before the initial review date (which is within two weeks of the posting date).

If within the initial review no candidate was selected to fill the position posted, additional applications will be considered for the posted position; however, the posting will close once a finalist is identified, and at minimal, two weeks after the initial posting date. Please note, that if no candidate were identified and hired within 90 days from initial posting, the posting would close for review, and possibly reposted at a later date.

Stony Brook Medicine is a smoke free environment. Smoking is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises.

All Hospital positions may be subject to changes in pass days and shifts as necessary.

This position may require the wearing of respiratory protection, which may prohibit the wearing of facial hair.

This function/position may be designated as “essential.” This means that when the Hospital is faced with an institutional emergency, employees in such positions may be…