Description

PRIMARY RESPONSIBLITIES:

• Accurately assigns diagnosis and procedure codes for inpatient facility and professional services such as inpatient stays, surgical procedures, dental surgical procedures, anesthesia services, ancillary services, and inpatient external resource sharing agreement (ERSA) encounters
• Ensures correct assignment of DRGs for inpatient stays and discharges, Relative Weighted Product (RWP) and Relative Value Units (RVUs)
• May assist with ambulatory and outpatient coding (experience in outpatient, APV and ED required)
• Assigning accurate ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities from medical record documentation (paper or electronic) for inpatient professional services (a.k.a., Rounds and Profee coding)
• Trains and educates Military Clinic/MTF (military treatment facility) staff on coding issues and plays a significant role in coding compliance activities
• Researches and resolves coding edit failures as assigned.

Requirements

CERTIFICATIONS: CIC, CCS, COC, RHIT, or RHIA (Must provide proof of active certification)

QUALIFYING SPECIALITIES INCLUDE: Inpatient stays /hospitalization, Major/Minor surgical procedures, Dental surgical procedures, Anesthesia services, Outpatient primary encounters/procedures, Outpatient specialty encounters/ procedures, Emergency Department, Observation, and Same Day Surgery (APV).

Billing, Denial Management, Radiology/Laboratory, and HCC coding is NOT CONSIDERED qualifying for this role.

EXPERIENCE: Coding personnel in this position are required to possess a minimum of five (5) years of inpatient medical coding and/or auditing experience in two (2) or more medical, surgical, and ancillary specialties within the past 10 years; OR a minimum of three (3) years of inpatient medical coding or auditing experience if that experience was in an MTF. A minimum of one (1) year of performance in the specialty is required to be documented to be considered qualifying. (Resume must reflect all experience, and MTF experience if applicable)

Must be a US Citizen and reside in the US or a US Territory.