Inpatient Coder I

Remote work from Illinois, Wisconsin, Indiana, and Iowa

Description

The Inpatient Coder I reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

The Inpatient Coder I is the coding and reimbursement expert for ICD-10-CM diagnosis coding and ICD-10-PCS procedure coding for lower complexity inpatient acute care discharges. This individual has an understanding of disease process, anatomy/physiology, pharmacology, and medical terminology.

This position is 100% remote. MUST RESIDE IN IL, IN, IA, OR WI.

Responsibilities:

• Utilizes technical coding expertise to assign appropriate ICD-10-CM and ICD-10-PCS codes to inpatient acute care visit types up to 6 days length of stay across all Medical and Surgical service lines.. Complexity is measured by a Case Mix Index (CMI) and Coder I’s typically see average CMI’s of 1.4 with this mix of the acute care population. This index score demonstrates mid-range patient complexity and acuity.
• Utilizes expertise in clinical disease process and documentation, to assign Present on Admission (POA) values to all secondary diagnoses for quality metrics and reporting.
• Thoroughly reviews the provider notes within the health record and the Findings from the Clinical Documentation Nurse in the Clinical Documentation Improvement (CDI) Department who concurrently reviewed the record and provide their clinical insight on the diagnoses.
• Utilizes resources within CAC (Computerized Assisted Coding) software to efficiently review documentation and select or assign ICD-10-CM/PCS codes using autosuggestion or annotation features.
• Reviews Discharge Planning and nursing documentation to validate and correct when necessary, the Discharge Disposition which impacts reimbursement under Medicare’s Post-Acute Transfer Policy.
• Utilizes knowledge of MS-DRG’s, APR-DRG’s, AHRQ Elixhauser risk adjustment to sequence the appropriate ICD-10-CM codes within the top 24 fields to ensure correct reimbursement and NM’s ranking in US News and World Report.
• Collaborate with CDI on approximately 20% of discharges regarding the final MS or APR DRG and comorbidity diagnoses.
• Educates CDI on regulatory guidelines, Coding Clinics and conventions to report appropriate ICD-10-CM diagnoses.
• Interprets health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, medical terminology to determine the Principal Diagnosis, secondary diagnoses and procedures.
• Follows the ICD-10-CM Official Guidelines for Coding and Reporting, ICD-10-PCS Official Guidelines for Coding and Reporting, Coding Clinic for ICD-10-CM and ICD-10-PCS, coding conventions and instructional notes to assign the appropriate diagnoses and procedures.
• Resolves Nosology Messages/Alerts and Coding Validation Warning/Errors.
• Meets established coding productivity and quality standards.

Qualifications

Required:

• 1 year of inpatient coding experience in an acute healthcare or inpatient rehabilitation setting or progressive coding experience internally. Must have formal training in PCS coding.
• RHIA, RHIT or CCS credential
• AHIMA membership

Preferred:

• Associate’s degree in related field
• 2 years of inpatient coding experience in an acute healthcare setting that includes a teaching hospital

Equal Opportunity

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.