Lead HIM Hospital Coder​/Auditor; In-Patient - Observation

Position Summary / Career Interest:
The Health Information Management (HIM) Inpatient/Observation Hospital Coder Auditor/Lead responsibilities include reviewing all diagnosis and procedural coding in ICD-10-CM/PCS for accurate DRG assignment. This position will have daily interactions with internal and external customers to include physicians, hospital support services and ancillary departments. The HIM Inpatient/Observation Hospital Coder Auditor/Lead will perform inpatient/outpatient coding compliance audits and provide coder education. This position will assist in the preparation and finalization of auditing reports.

• Monitors coding compliance and case mix comparison for select outpatient, same day surgery and inpatient accounts.
• Works in conjunction with the Clinical Documentation Improvement (CDI) team to provide comprehensive medical record documentation and achieve accurate DRG assignment and appropriate mortality and severity scores.
• Validates HIDI, KHA and other external data reporting accuracy, while obtaining target coding trends for improvement.
• Completes focused record reviews based on benchmarking data from UHC and other quality reports quarterly.
• Identifies unspecified diagnoses used and determines if documentation supports a more specific diagnosis.
• Works with Coding Supervisor/Manager on record review projects.
• Provides coding expertise for data reporting activities while employing all federal regulations and coding guidelines.
• Provides education/training to physicians and other providers on coding and DRG assignment.
• Reviews the complex (problematic coding that needs research and reference checking) medical records and accurately codes the primary/secondary diagnoses and procedures using ICD-10-CM/PCS coding conventions.
• Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM/PCS coding guidelines to inpatient and outpatient diagnoses and procedures.
• Provides high-level analysis of trends to Management, Revenue Managers and others about coding related issues.
• Researches and identifies trends in unbilled accounts.
• Coordinates quality reporting measures with providers, revenue managers and management.
• Assists supervisor in training new hires and other coders within the department.
• Performs audits on coding accuracy and/or DRG assignment to comply with corporate compliance responsibilities to include RAC and insurance revision requests and appeals.
• Prepares materials for presentation for continuing education to applicable internal and external customers.

• Required:
  
  Associate’s Degree in Health Information Management or a related field of study from an accredited college or university.
• Required:
  
  5 or more years of coding experience in inpatient and/or outpatient ICD-10 CM/PCS.
• Required:
  
  1 or more years of auditing experience utilizing ICD-10 CM/PCS.
• Preferred:
  Bachelor’s Degree in Health Information Management or a related field of study from an accredited college or university.
• Preferred: 7 or more years of Epic experience.

• RHIT, RHIA or CCS certification.

• Fluent English – must be able to read, write, and speak English.

• Expertise in MS-DRG Optimization, APR DRG, RAC/HAC/Core Measures.
• Coding accuracy: 95% or better in accordance with HIM Quality Analysis Policy.

Full time

The health system is an equal employment opportunity employer. Qualified applicants are considered for employment…