Job Description:
Codes and abstracts hospital health record data using International Classification of Diseases Clinical Modification and Procedure Coding System (ICD-10-CM and PCS) at an advanced level of complexity.
Scope
This position assigns ICD-10 Clinical Modification (CM), Hierarchical Condition Category (HCC), and ICD-10 Procedure Classification System (PCS) codes and Diagnosis Related Groups (DRG) to ensure accurate billing data for patient populations and publicly reported data. This position uses extensive knowledge and expertise to work alongside and collaborate with Clinical Documentation Integrity to review complex inpatient facility encounters and assign ICD-10 CM and PCS codes based on provider and clinical documentation. It utilizes appropriate tools, resources, and guidelines to determine codes and assign the principal diagnosis and secondary diagnoses. Obtains clarification from physicians, clinical departments, and others on documentation questions as needed. Performs coding at an advanced level of complexity. Audits and edits results of data provided by technology tools and resolves edits to send out a clean and accurate claim. Performs coding at an advanced level of complex inpatient hospital coding complexity, such as Medicare and Medicaid charts with extended length of stay and multiple surgeries with extended consultations. Collaborates with internal patient access to acquire correct and compliant diagnosis(es) to meet Advance Beneficiary Notice of Noncoverage (ABN) requirements and compliant billing regulations. Maintains assigned work queues within defined processing time, meets productivity standards, and meets quality standards of 95% accuracy or better. Utilizes critical thinking to assign appropriate clinical diagnosis and procedure codes in accordance with nationally recognized guidelines. Verifies data abstracted and entered from the electronic health record (EHR). Ensures integrity of the database for internal and external data reporting. Responds promptly to inquiries from revenue services related to the use of codes and modifiers within the billing process to assure accuracy and avoid delays in the billing process. Adheres to all internal and external compliance guidelines. Participates in continuing education programs to maintain an understanding of anatomy, physiology, medical terminology, disease processes, and surgical techniques to support the effective application of coding guidelines and maintains credentials. Stays abreast of coding guidelines, reimbursement methodologies, and regulatory compliance. Maintains thorough and current knowledge of clinical care and treatment options to critically assess appropriateness of documentation. Thorough clinical knowledge of disease processes, pathophysiology, and pharmacology is required. Assists as needed with billing/audit questions to ensure accurate reimbursement, facility inquiries, education, statistical analysis, and the processing of internal audit reviews. Identifies the need to clarify documentation in the medical record and communicates with physicians using the appropriate “query” tools according to the American Health Information Management Association (AHIMA) Guidelines for Achieving a Compliant Query Practice. Promotes the mission, vision, and values of Intermountain Health, and abides by service behavior standards. Minimum Qualifications
Coding credential from AHIMA or American Academy of Professional Coders (AAPC) required OR ten (10) years of acute care inpatient facility coding experience. Ability to work independently in a remote environment. Demonstrates attention to detail for accuracy requirements. Preferred Qualifications
Minimum of three (3) years acute care facility coding experience which includes both ICD-10-CM & PCS coding with multidisciplinary service lines. Understanding of billing, hospital reimbursement, and compliance background. Ability to communicate effectively and diplomatically within a multi-functional team. Experience with EPIC EHR and 3M 360 CAC, using 3M automation tools. Experience with Microsoft Suite (Excel, Word, Outlook). Physical Requirements:
Remain sitting or standing for long periods of time to perform work on computer. See and read computer monitors and documents. Interact with others requiring the employee to communicate information. Operate computers and other equipment requiring the ability to move fingers and hands. Location:
Peaks Regional Office Work City:
Broomfield Work State:
Colorado Scheduled Weekly Hours:
40 Compensation:
The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $23.30 - $35.48 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All positions subject to close without notice.
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This position assigns ICD-10 Clinical Modification (CM), Hierarchical Condition Category (HCC), and ICD-10 Procedure Classification System (PCS) codes and Diagnosis Related Groups (DRG) to ensure accurate billing data for patient populations and publicly reported data. This position uses extensive knowledge and expertise to work alongside and collaborate with Clinical Documentation Integrity to review complex inpatient facility encounters and assign ICD-10 CM and PCS codes based on provider and clinical documentation. It utilizes appropriate tools, resources, and guidelines to determine codes and assign the principal diagnosis and secondary diagnoses. Obtains clarification from physicians, clinical departments, and others on documentation questions as needed. Performs coding at an advanced level of complexity. Audits and edits results of data provided by technology tools and resolves edits to send out a clean and accurate claim. Performs coding at an advanced level of complex inpatient hospital coding complexity, such as Medicare and Medicaid charts with extended length of stay and multiple surgeries with extended consultations. Collaborates with internal patient access to acquire correct and compliant diagnosis(es) to meet Advance Beneficiary Notice of Noncoverage (ABN) requirements and compliant billing regulations. Maintains assigned work queues within defined processing time, meets productivity standards, and meets quality standards of 95% accuracy or better. Utilizes critical thinking to assign appropriate clinical diagnosis and procedure codes in accordance with nationally recognized guidelines. Verifies data abstracted and entered from the electronic health record (EHR). Ensures integrity of the database for internal and external data reporting. Responds promptly to inquiries from revenue services related to the use of codes and modifiers within the billing process to assure accuracy and avoid delays in the billing process. Adheres to all internal and external compliance guidelines. Participates in continuing education programs to maintain an understanding of anatomy, physiology, medical terminology, disease processes, and surgical techniques to support the effective application of coding guidelines and maintains credentials. Stays abreast of coding guidelines, reimbursement methodologies, and regulatory compliance. Maintains thorough and current knowledge of clinical care and treatment options to critically assess appropriateness of documentation. Thorough clinical knowledge of disease processes, pathophysiology, and pharmacology is required. Assists as needed with billing/audit questions to ensure accurate reimbursement, facility inquiries, education, statistical analysis, and the processing of internal audit reviews. Identifies the need to clarify documentation in the medical record and communicates with physicians using the appropriate “query” tools according to the American Health Information Management Association (AHIMA) Guidelines for Achieving a Compliant Query Practice. Promotes the mission, vision, and values of Intermountain Health, and abides by service behavior standards. Minimum Qualifications
Coding credential from AHIMA or American Academy of Professional Coders (AAPC) required OR ten (10) years of acute care inpatient facility coding experience. Ability to work independently in a remote environment. Demonstrates attention to detail for accuracy requirements. Preferred Qualifications
Minimum of three (3) years acute care facility coding experience which includes both ICD-10-CM & PCS coding with multidisciplinary service lines. Understanding of billing, hospital reimbursement, and compliance background. Ability to communicate effectively and diplomatically within a multi-functional team. Experience with EPIC EHR and 3M 360 CAC, using 3M automation tools. Experience with Microsoft Suite (Excel, Word, Outlook). Physical Requirements:
Remain sitting or standing for long periods of time to perform work on computer. See and read computer monitors and documents. Interact with others requiring the employee to communicate information. Operate computers and other equipment requiring the ability to move fingers and hands. Location:
Peaks Regional Office Work City:
Broomfield Work State:
Colorado Scheduled Weekly Hours:
40 Compensation:
The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $23.30 - $35.48 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All positions subject to close without notice.
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