Job Description
The Inpatient Coder Associate reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
The Inpatient Coder Associate is the coding and reimbursement expert for ICD-10-CM diagnosis coding and ICD-10-PCS procedure coding for up to 3 day length of stay Obstetric and Newborn inpatient acute care discharges. This position has an understanding of disease process, anatomy/physiology, pharmacology and medical terminology.
The Inpatient Coder Associate understands IRF-PAI (Inpatient Rehabilitation Facility Patient Assessment Instrument) guidelines. This individual must have a working knowledge of the IGC (Impairment Group Codes) and RIC (Rehabilitation Impairment Categories) as it relates to the primary diagnosis selection and claim reimbursement for acute rehab records.
This position is 100% remote. MUST RESIDE IN IL, IN, IA, OR WI.
** Responsibilities:**
- Utilizes technical coding expertise to assign appropriate ICD-10-CM and ICD-10-PCS codes to acute rehab cases and inpatient OB and Newborn discharges. Complexity is measured by a Case Mix Index (CMI) and IP Coder Associate’s typically see average CMI’s of 0.5759 with the OB and Newborn population. This index score demonstrates lower patient complexity and acuity.
- Utilizes expertise in clinical disease process and documentation, to assign Present on Admission (POA) values to all secondary diagnoses for quality metrics and reporting.
- Thoroughly reviews the provider notes within the health record and the Findings from the Clinical Documentation Nurse in the Clinical Documentation Improvement (CDI) Department who concurrently reviewed the record and provide their clinical insight on the diagnoses for Inpatient Rehab patients only.
- Utilizes resources within CAC (Computerized Assisted Coding) software to efficiently review documentation and select or assign ICD-10-CM/PCS codes using autosuggestion or annotation features.
- Reviews Discharge Planning and nursing documentation to validate and correct when necessary, the Discharge Disposition which impacts reimbursement under Medicare’s Post-Acute Transfer Policy.
- Utilizes IRF-PAI knowledge to identify appropriate Etiologic Diagnoses and Comorbid conditions on Rehab records.
- Collaborate with CDI and PPS concurrently with Rehab records since coding impacts patient’s anticipated length of stay.
- Interprets health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, medical terminology to determine the Principal Diagnosis, secondary diagnoses and procedures.
- Follows the ICD-10-CM Official Guidelines for Coding and Reporting, ICD-10-PCS Official Guidelines for Coding and Reporting , Coding Clinic for ICD-10-CM and ICD-10-PCS, coding conventions and instructional notes to assign the appropriate diagnoses and procedures.
- Resolves Nosology Messages/Alerts and Coding Validation Warning/Errors.
- Meets established coding productivity and quality standards.