Coder I - Inpatient Coder

Overview HonorHealth is a non-profit, local community healthcare system serving an area of 1.6 million people in the greater Phoenix area. The network encompasses six acute-care hospitals, an extensive medical group, outpatient surgery centers, a cancer care network, clinical research, medical education, a foundation and community services with approximately 12,300 employees, 3,700 affiliated physicians and 3,100 volunteers. HonorHealth was formed by a merger between Scottsdale Healthcare and John C. Lincoln Health Network. HonorHealth's mission is to improve the health and well-being of those we serve. As a community healthcare system, we have a unique responsibility to keep our facilities as safe as possible to protect our patients and team members. With this in mind, we require all new hires to have received the first dose of a COVID-19 vaccine before their start date and be scheduled for their second dose. New hires who choose to receive the Johnson & Johnson vaccine only need one dose to fulfill this requirement. Reasonable accommodations will be considered. Responsibilities Job Summary Assigns and sequences ICD-10-CM, ICD-10-PCS, CPT and HCPCS codes through review of inpatient or outpatient clinical documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance. Inpatient: Assigns and sequences ICD-10-CM and ICD-10-PCS diagnostic and procedural codes for inpatient accounts within HonorHealth. Reviews physician documentation & coding for appropriateness & accuracy and makes corrections following Medicare & AMA coding guidelines. Utilizes electronic medical record and computer-assisted coding (CAC) software. Addresses applicable coding edits. Assigns DRGs as applicable. Outpatient: Assigns and sequences ICD-10-CM, CPT and HCPCs diagnostic and procedural codes for outpatient accounts within HonorHealth. Reviews physician documentation & coding for appropriateness & accuracy and makes corrections following Medicare & AMA coding guidelines. Utilizes electronic medical record and computer-assisted coding (CAC) software. Addresses NCCI, OCE, LCD, and other applicable coding edits. Inpatient: Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. Reviews and analyzes medical records for accurate ICD code selection. Outpatient: Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. Reviews and analyzes medical records for accurate ICD and CPT code selection. Inpatient/Outpatient: Communicates and assists in education with an audience that may include physicians and clinical staff. Inpatient: Assists Patient Financial Services with interpretation and selection of appropriate ICD codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of failed bill parameters. Outpatient: Assists Patient Financial Services with interpretation and selection of appropriate ICD, CPT, and HCPCs codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of failed bill parameters. Inpatient/Outpatient: Performs outpatient charge validation/reconciliation for outpatient coding to ensure all submitted charges are posted timely and balance with total submitted charges. Assigns charges as applicable. Inpatient/Outpatient: Resolves routine coding issues/problems and appropriately seeks assistance from supervisor. Performs other duties as assigned. Qualifications Education High School Diploma or GED Required Experience Other Inpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM and ICD-10-PCS codes. Outpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM, CPT, and HCPCs codes. Required Licenses and Certifications CCA (Certified Coding Apprentice) with successful certification of CCS in 6 months OR Inpatient: CCS (Certified Coding Specialist), or CIC (Certified Inpatient Coder), or RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator) Outpatient: CPC-H (Certified Professional Coder-Hospital Outpatient), or CPC (Certified Professional Coder), or COC (Certified Outpatient Coder), or CCS (Certified Coding Specialist), or RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator) Required