Senior Inpatient APR-DRG Coding Specialist

Job Description Summary

Provides accurate assignment of ICD-10-CM diagnoses, procedure codes, and proper APR-DRG grouping for pediatric inpatient and interim accounts. Required to meet daily metrics for quality and quantity.

Essential Functions

• Codes 20-25 inpatient charts or 8-10 interim inpatient accounts per day and meets 95% quality.
• Strives to meet weekly coding deadlines and complete all inpatient accounts within the 5-day bill hold period.
• Properly assigns principal and all secondary diagnoses as appropriate.
• Directly influences hospital reimbursement by using appropriate tools to determine APR-DRG.
• Works extensively with CAC (computer-assisted coding) engine and validates codes identified.
• Collaborates and communicates effectively on coding mismatches and follow-ups.
• Utilizes professional associations, Libman, and other resources to familiarize self with new diagnoses, procedures, and coding guidelines.

Education Requirement

• As required by listed licensure and/or certification requirement.
• Graduate of Health Information Technology program, preferred.

Certifications

• Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Outpatient Coder (COC), required.
• Certified Coding Specialist (CCS) within 48 months of hire, required.

Experience

• Five years of experience as an Inpatient APR-DRG coder in a free-standing pediatric hospital or combination of related experience, required.
• Experience working with CDI team, required.
• Epic experience, preferred.

Physical Requirements

Occasionally

• Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Hand use: grasping, gripping, turning, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking
• FREQUENTLY: (none specified)

Continuously

Computer skills, Decision Making, Interpreting Data, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting

"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"