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Clinical Coding Specialist III (Inpatient)

Company: Boca Raton Regional Hospital
Location: Boca Raton
Posted on: December 9, 2018

Job Description:

POSITION SUMMARY: HIM Coders are responsible for coding medical records according to ICD-10-CM and CPT coding guidelines. The primary functions of this position are: to review medical record documentation for inpatient encounters, assigning appropriate diagnostic and procedural codes and modifiers; and capture of quality management and statistical data elements for organizational reporting. Codes are assigned as appropriate to each diagnosis and procedure documented in the medical record by the physician. POSITION EXPECTATIONS AND RESPONSIBILITIES:

  • Abstract and enter coded data and designated quality management and statistical information for hospital reporting requirements. Coder holds and routes medical records concurrently for various designated studies reviews/studies.
  • Review and respond to identified encoder DRG and other Payer edits during the data abstraction process prior to completion of coding and billing.
  • Assists in the resolution of identified DRG and other payer edit issues upon notification by administrative entities.
  • Makes appropriate corrections to claims requiring ICD-10-CM procedure or diagnoses code changes.
  • Participates in quality reviews for performance improvement
  • Review inpatient encounters for the determination and accurate assignment of all appropriate documented diagnoses, procedures and modifiers, utilizing ICD-10-CM, CPT-4 and any other designated codification systems.
  • Assign as appropriate DRG, APR, and/or APC for all medical records using the automated grouper/encoder.
  • Other duties as assigned. MINIMUM EDUCATION AND/OR EXPERIENCE:
    • Graduate of an accredited school of Health Information Management with Certification as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), OR certification as a Certified Coding Specialist (CCS) (or eligible within 12 months). Prior clinical inpatient and/or outpatient coding experience through an accredited educational program or verifiable work experience. Has a minimal knowledge/experience with hospital information systems application and Microsoft WINDOWS.
    • 2 3 years of inpatient coding experience. Licensure/Regulation/Certification:
      • Registered Health Information Management (RHIT) certification or
      • Registered Health Information Administrator (RHIA) certification or
      • Certified Coding Specialist (CCS) certification OR
        • Eligible for certification and must obtain certification within 12 months of hire date. *Incumbent may be required to perform emergency duty before, during and/or beyond normal work hours or days in the event of an emergency, crisis situation or disaster (man-made or natural) including evacuation sites. *The person in this position will work in a smoke-free location, and is expected to adhere to all smoking restrictions. *In the spirit of wellness for both our employees and patients, Boca Raton Regional Hospital has instituted a mandatory influenza prevention vaccination program. Current employees must receive the influenza prevention vaccination free of charge during the recognized flu season. As a condition of employment, new hires will be required to comply with all program rules. This is a mandatory program with the exception of documented medical or religious reasons for not receiving the vaccine. For further information on this progressive program, please contact Boca Raton Regional Hospital's Human Resources Department at .

          Keywords: Boca Raton Regional Hospital, Miami , Clinical Coding Specialist III (Inpatient), Healthcare , Boca Raton, Florida

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