Inpatient Claims Edit Medical Coder

Title: Remote Inpatient Claims Edit Medical Coder

Location: United States

Full-Time

Job Details

Description

Position Summary:

This is a remote coding position. As an experienced IP/OP Claims Edit coder you will be responsible for providing coding and abstracting services for clients IP/OP records using ICD-10 CM/PCS and CPT/HCPCS coding systems. You will use established coding principles, software and your knowledge and experience to assign diagnostic and procedural codes after a thorough review of the medical record.

The coding editor will be responsible for correcting and final coding accounts. These accounts are primarily outpatient to inpatient patient class change accounts. Work will include:

• Checking diagnosis codes when appropriate
• Adding POA indicators on diagnoses
• Coding within the encoder to determine a DRG for inpatient stay
• Approving and completing OP to IP accounts
• Medical necessity clarification
• Reviewing denied claims
• Performing observation charge reviews
• Review/correcting account errors for final bill
• Reviewing modifiers/bundling/unbundling of accounts/edits

Essential Functions:

-Reviews medical records to identify pertinent diagnoses and procedures relative to the patient’s health care encounter.

-Selects the principal diagnosis and principal procedure, along with other diagnoses and procedures using UHDDS definition.

-Ensures appropriate DRG assignment.

-Abstracts appropriate information from the medical record based on the guidelines provided by the client and after a thorough review of the medical record.

-Solicits clarification from the physician regarding ambiguous or conflicting documentation in the medical record using guidelines provided by the client.

-Maintains current knowledge of the information contained in the Coding Clinic, CPT Assistant, and the Official Guidelines for Coding and Reporting.

Requirements:

-Strong working knowledge of inpatient claim edits

-EPIC & 3M experience preferred

-Must have a minimum of 3 years of IP claim edits experience; 5-7 years preferred.

-Some understanding of laboratory CPT codes

-Understands medical terminology, anatomy, physiology, surgical technology, pharmacology and disease processes.

-Extensive knowledge of ICD-10 CM/PCS and CPT/HCPCS coding principles and guidelines, reimbursement systems, federal, state and payor-specific regulations and policies pertaining to documentation, coding and billing.

-Must pass coding proficiency test.

Why Work for Aquity? We offer competitive benefits such as:

-Competitive salary

-Three weeks of paid time off (120 hours) annually

-Seven paid holidays annually

-Job related education reimbursement, CEU and credentials

-Opportunity to work remotely and can work flexible hours contingent on clients needs.

Qualifications

Experience

Required

3 years: Experience with E-request, Meditech, HPF.

3 years: At least 3 years of IP facility coding experience as well as experience with IP claim edits.

Licenses & Certifications

Required

Regd. Health Info Tech

Cert. Coding Specialist

Preferred

Regd. Health Info Admin