Medical Coder III
Job ID 2018-24848
Employment Type full-time
Hours Per Week 40
Onsite Work Schedule Details 8:30am – 5:00 PM (M-F)
The Coder III will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the needs of hospital data retrieval for billing and reimbursement. Specialists validate MSDRG and/or APC calculations in order to accurately capture the diagnoses/procedures documented in the clinical record. Coder III performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder III may interact with client staff and providers.
- Select and sequence ICD-9, ICD-10, and/or CPT/HCPCS codes for designated patient types which may include but not limited to: Acute Inpatient, Observation/Rehabilitation/Psychiatric/SNF, Ambulance and Ambulatory Surgery, Wound Care, Emergency Department, Ancillary (Diagnostic) / Recurring, Interventional Radiology, Hospital Clinic, Physician Pro Fee, Technical Fee, Evaluation and Management.
- Review and analyze clinical records to ensure that MSDRG/APC assignments accurately reflect the diagnoses/procedures documented in the clinical record.
- Abstract clinical data from the record after documentation review to ensure that it is adequate and appropriate to support diagnoses, procedures and discharge disposition is selected.
- Complete assigned work functions utilizing appropriate resources.
- May act as a resource with client staff for data integrity, clarification and assistance in understanding and determining appropriate and compliant coding practices including provider queries.
- Maintain strict patient and provider confidentiality in compliance with all federal, state, and hospital laws and guidelines for release of information.
- Participate in client and nThrive staff meetings, trainings, and conference calls as requested and/or required.
- Maintain current working knowledge of ICD and/or CPT/HCPCS and coding guidelines, government regulations, protocols and third-party requirements regarding coding and/or billing.
- Participate in continuing education activities to enhance knowledge, skills, and maintain current credentials.
- Supports nThrive’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to nThrive’s business practices. This includes: becoming familiar with nThrive’s Code of Ethics, attending training as required, notifying management or nThrive’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.
- Active RHIA or RHIT or CCS, CCA, COC (formerly CPC-H), CCS-P, CPC.
- 3+ years of recent and relevant hands-on coding experience with all record types: Acute Inpatient, Observation/Rehabilitation/Psychiatric/SNF, Ambulance and Ambulatory Surgery, Wound Care, Emergency Department, Ancillary (Diagnostic) Recurring, Interventional Radiology, Hospital Clinic, Physician Pro Fee, Technical Fee, Evaluation and Management.
- Knowledge of medical terminology, anatomy and physiology, pharmacology, pathophysiology, as well as ICD and CPT/HCPCS code sets.
- Ability to consistently code at 95% threshold for both accuracy and quality while maintaining client-specific and/or nThrive production and/or quality standards.
- Proficient computer knowledge including MS Office (Outlook, Word, Excel).
- Must display excellent interpersonal and problem solving skills with all levels of internal and external customers.
- Associate degree in HIM or healthcare-related field.
- Other credentials such as: Certified Gastroenterology Coding Specialist (CGCS) or CIC a plus.
Be Inspired. Ignite Change. Transform Health Care.
From Patient-to-PaymentSM, nThrive provides all the technology, advisory expertise, services, analytics and education programs health care organizations need to thrive in the communities they serve. Our colleagues share a united passion to help health care organizations strengthen their financial position, which translates to accessible, quality care for all. This passion fuels our drive to innovate and participate in community outreach through the nThrive CARES program. Our colleagues are encouraged to think differently and empowered to make a lasting impact that ensures our health care providers, and our world, are healthy and productive.