Senior Inpatient Coder (REMOTE)

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Job Summary: The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the current International Classification of Diseases (ICD10 CM/PCS codes). The role involves entering coded information into an automated grouper system. Technical guidance and acting in a lead role are expected.

Responsibilities:

1. Address appeals to insurance denials to facilitate expedient resolution and reimbursement.
2. Interpret and apply American Hospital Association Official Coding guidelines to support diagnoses and procedures.
3. Identify and report patterns of coding errors or trends to the coding leadership team.
4. Participate in mandated medical record review processes.
5. Assign accurate codes to diagnoses, procedures, and operations based on documentation.
6. Query physicians for documentation clarification.
7. Ensure all factors necessary for accurate DRG assignment are present and diagnoses are ranked properly.
8. Compile and update appeal logs related to denials and responses.
9. Provide information and respond to inquiries regarding medical documentation and DRGs to hospital staff.
10. Abstract information from medical records for reports and statistics.
11. Potentially train lower-level coders and provide guidance.
12. Resolve bill holds promptly to maintain DNFB and coding queues.
13. Act as a liaison between Patient Accounting and Coding departments.

Qualifications:

• Minimum of three years inpatient coding experience in an acute care setting.
• Proficiency in ICD10 CM and ICD10 PCS, demonstrated through assessment.
• High School diploma or equivalent; substitution with credits toward an associate or bachelor's degree is possible.
• Current certification as a CCS is required; RHIA or RHIT preferred.
• Knowledge of AHA coding guidelines, ICD10 codes, DRG systems, medical terminology, anatomy, and physiology.
• Effective communication skills and proficiency with computer applications.

Additional Details:

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Health Care Provider
• Industries: Hospitals and Health Care

This job posting is active and accepting applications.