Inpatient Senior Coder - Remote

JOB SUMMARY 

Responsible for assigning diagnostic and procedural codes to inpatient charts using ICD-10-CM and ICD-10-PCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Performs inpatient coding quality/second level reviews, inpatient denial reviews, provides consultation on projects, and may be primary point of contact for team members and other departments when supervisor/manager is not available. Acts as a resource and subject matter expert for the inpatient coding team. 

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Coding: Reviews medical records for the determination of accurate code assignment of all documented diagnoses and procedures in accordance with Official Coding Guidelines. Adheres to Standards of Ethical Coding (AHIMA).  
• Abstracting: Reviews medical records to determine accurate required abstracting elements (facility/client specific elements) including appropriate discharge disposition.
• Coding Quality: Demonstrates consistency in achieving or exceeding 95.5% coding accuracy in the selection of principal and secondary diagnoses (including DRG, MCC & CC, SOI/ROM) and procedures. Demonstrates accuracy and consistency in abstracting elements defined by per facility.
• Coder Productivity: Meets and/or exceeds Conifer’s inpatient coding productivity guidelines
• Physician Queries: Demonstrates strong skills in creating appropriate and compliant physician retrospective coding queries.  
• Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and ICD-10-PCS coding. Completes mandatory coding education as assigned. Quarterly review of AHA Coding Clinic. Attends all required coding operations conference calls.
• DNFB: Reviews held accounts daily for resolution in support of coding DNFB performance. Communicates barriers to leaders (physician queries, missing documentation, second level review, DRG reconciliation, etc.) for appropriate follow-up and resolution. Provides operational performance reports to leadership as requested.  

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Strong knowledge of MS-DRG and APR DRG classification and reimbursement structures
• Proficient at writing AHIMA compliant physician queries
• Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness and elevating concerns to the appropriate manager
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