Inpatient Coding Team Member (Remote)
Job ID: SSS-1901556
Location: Roseville, California
Assigns codes and modifiers into the hospital encoder system within established Health Information Management standards. Abstracts and codes Inpatient records and all others as assigned based on deep functional expertise. Determines principal and secondary diagnoses and procedures for Inpatient records, regardless of complexity, according to all applicable coding rules and regulatory standards. Assigns medical diagnoses and surgical procedure codes and abstracts necessary data elements for billing, reimbursement and state reporting. These codes are used to calculate the MS-DRG assignment required for reimbursement, as well as the APR DRG used for Quality metrics and analysis. This data is used to establish a statistical database which is used throughout the organization for medical staff improvement activities, clinical effectiveness and outcome studies, medical staff credentialing, administrative planning, researched and to meet regulatory reporting requirements.
Ensures all collected data is accurate, complete and compliant with state and federal regulations as well as Official Guidelines for Coding and Reporting and Sutter defined coding policies and procedures. This position ensures that all hospital based encounters, both inpatient and outpatient, are coded, abstracted and finalized accurately and in accordance with defined service level agreements.
Supports the success of a high-performing shared services organization by helping to champion and drive the long-term Sutter Shared Services vision. Helps foster an environment in which continuous improvement in business processes and services is welcomed and recognized. Participates in programs and in using tools in support of building a high performance culture via the standard Sutter Shared Services responsibilities (e.g. performance measurement, people development, customer relationship management, etc.).
High school diploma/GED required.
AA/AS degree or equivalent combination of education and experience desired.
Certified Coding Specialist (CCS) required.
Registered Health Information Technician (RHIT) desired.
Demonstrates experience and a proven track record in Coding in a facility of significant size and complexity, hospital business operations, information systems, and coding applications, as typically acquired in 0-2 years of experience performing acute care inpatient, outpatient, and/or emergency department coding
Experience participating in Coding standards, processes, policies, procedures and service level agreements
Experience in complex regional/ shared service environment with multiple/ matrix reporting relationships preferred
Knowledge of hospital inpatient, outpatient, and/or emergency department coding rules, Ambulatory Payment Classifications and Diagnosis Related Group assignment logic, National Correct Coding Initiative edits, Coding Clinic and Current Procedural Terminology Assistant coding guidelines
In-depth knowledge of medical terminology, disease processes, patient health record content and the medical record coding process
Knowledge of computer based encoder systems and accurate data entry skills
Strong working knowledge of anatomy, physiology and pharmacology
Familiarity with billing functions and the components of a charge description master
General knowledge of Revenue Cycle applications, including Electronic Health Record systems
General knowledge/ awareness of all areas related to Coding and how they interrelate
Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections
Familiarity with Coding management functions in acute and non-acute settings
Knowledge of Patient Management information system applications, preferably EPIC
Ability to work closely with medical staff and other departments to c…