Inpatient Reimbursement Coding Specialist - UI Health, Health Information Management
Summary
Assigns ICD-10-CM/PCS codes and DRG/APR-DRG groups for inpatient hospital records, resolves denials, and collaborates with clinical teams to ensure accurate billing and documentation.
UI Health is seeking an experienced Inpatient Reimbursement Coding Specialist to join our Health Information Management team. This Inpatient Reimbursement Coding Specialist applies ICD-10-CM and ICD-10-PC codes and POA indicators to Inpatient hospital accounts. The position requires knowledge of sequencing, diagnosis, and procedures according to coding guidelines for complex accounts to assign the correct DRG or APR-DRG. Also, this position requires the ability to collaborate with a Clinical Documentation Specialist (CDS) to ensure accurate documentation and coding on accounts. Duties Responsibilities: Ability to sequence and assign ICD-10-CM/PCS diagnosis and procedure codes to complex inpatient visits by following the coding guidelines. Proficient in interpreting medical documentation to determine the principal diagnosis and procedures codes and to assign the correct Present on Admission (POA) indicator to all codes Assigns the correct Diagnosis Related Groups (DRG) and All Patient Refined (APR-DRG) while adhering to coding guidelines for sequencing. Ability to write a compliant physician query and collaborate with Clinical Documentation Improvement (CDI) to clarify or resolve conflicting documentation prior to assigning final codes on inpatient accounts. Ability to utilize the Computer Assistant Coding (CAC) software to review medical documentation and select codes for billing and reporting purposes. Analyze and resolve coding denials from insurances companies and patient accounts. Follows internal workflows for accounts that has documentation or other errors that has to be resolved before coding. Follows the official ICD-10-CM, ICD-10-PC guidelines for coding and reporting. Keeps up to date on coding changes and other changes to regulations that governs medical record coding and documentation. Ability to maintain the national standards for coding accuracy and internal standards for productivity Maintains continuing educations hours as dictated by certification standards. Maintains confidentiality of patient health information Perform other related duties and participate in special projects as assigned.