HIM Coder III

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Job Description:

  • Responsible for timely and accurate coding and abstracting of Inpatient visits
  • Codes and abstract patients following established coding guidelines and utilizing ICD-10 code sets
  • Ensures that revenue cycle, customer service, quality, individual, and team goals are met
  • Thoroughly review of inpatient encounter documentation for diagnoses, treatments, services
  • Performs daily coding and abstracting utilizing ICD-10 Code sets and DRG Grouping systems
  • Validates MS-DRG and APR-DRG assignment for appropriateness to encounter
  • Performs weekly coding of Inpatient Interim Bill Requests
  • Review of Clinical Documentation Specialists notes and queries to ensure capture of queried conditions
  • Validates admission diagnosis assignment and coordinates correction with Case Management personnel when appropriate
  • Identifies documentation issues that may lead to incorrect coding, billing, and quality metrics
  • Communicates issues to Clinical Documentation Specialists for clarification and/or resolution when appropriate
  • Facilitates accurate Hospital Acquired Conditions reporting with Infection Control and/or coordinates retrospective query with CDI team as appropriate
  • Performs research and/or seeks assistance from Nosology, CHA and American Hospital Association on complex coding cases
  • Documents findings and educates team on coding guidance
  • Makes recommendations on Epic coding and SVC edits to prevent coding, billing, IHA and claim edits
  • Maintains quality standards of AHA, AMA, CMS, OIG and TJC pertaining to coding and reimbursement
  • Stay current in Coding changes by reading, maintaining CEUs, and attending education sessions related to Coding and Health Information Management
  • Trains and orients new employees
  • Assists with testing and implementation of systems/product changes and upgrades
  • Performs other duties as assigned by the coding manager or the director

Requirements:

  • Must possess a minimum of CCS, RHIA, or RHIT credential
  • Must maintain credential status through obtaining continuing education requirements
  • Must have completed and continue to demonstrate proficiency in coding program curriculum to include full courses Medical Terminology, Anatomy and Physiology, Medical Sciences, Pharmacology, ICD-10-CM, CPT, and Healthcare Data Content Structures
  • Completion of an AHIMA approved RHIT, RHIA, or CCS program
  • Must pass Lurie Children’s Coding Exam with a minimum of 90% score
  • Minimum of one year prior hospital coding experience required
  • Inpatient APR DRG experience preferred
  • Must have a working proficiency of Microsoft Office applications and computer skills to effectively navigate an EMR
  • Must be able to type a minimum of 30 Wpm
  • Must be able to communicate effectively with all Lurie staff; clinical, clerical, management
  • Excellent communication skills necessary for interaction at all levels of staff
  • Must be able to communicate effectively with external contacts: outside vendors as required in the execution of problem solving activities and assisting patients/visitors with their needs
  • Ability to handle multiple projects
  • Ability to appropriately prioritize tasks
  • Ability to cope with the inherent pressures of a results deadline oriented position

Benefits:

  • Medical, dental and vision insurance
  • Employer paid group term life and disability
  • Employer contribution toward Health Savings Account
  • Flexible Spending Accounts
  • Paid Time Off (PTO), Paid Holidays and Paid Parental Leave
  • 403(b) with a 5% employer match
  • Various voluntary benefits: Supplemental Life, AD&D and Disability, Critical Illness, Accident and Hospital Indemnity coverage
  • Tuition assistance
  • Student loan servicing and support
  • Adoption benefits
  • Backup Childcare and Eldercare
  • Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members
  • Discount on services at Lurie Children’s facilities
  • Discount purchasing program
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