Grady Health

Job Description

Location : Atlanta, GA

Status : Full Time

The Lead Inpatient Coder must have the ability to code inpatient records above the minimum performance levels, in accordance with UHDDS Definitions to validate an inpatient admit order, assignment of and sequencing of ICD-10-CM/PCS principal and secondary diagnoses, principal and secondary procedures, the discharge disposition codes and the DRG Assignment. Solid knowledge of MS-DRG, APR-DRG, Coding Guidelines, American Hospital Association (AHA) Coding Clinic and Present on Admission (POA) Indicator Guidelines. Knowledge of Hospital Acquired Conditions (HACs) and selected AHRQ Patient Safety Indicators (PSIs). Manage and resolve Inpatient Claim Edit WQ’s daily. Collaborates with the Patient Financial Services (PFS) to resolve payor denials due potential code assignment concerns. Assist with DRG payor review appeals final determination responses. Oversight of Inpatient Account WQs. Assist with 3M/Epic Coding Upgrade End-user Testing.

QUALIFICATIONS

• High School Diploma or GED, Required.
• Certified Coding Specialist (CCS) in an acute care hospital coding setting, Required.

. Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT), a Plus.

• Five (5) or more years of Inpatient Coding and Revenue Cycle experience in an acute care hospital, Required.

. Level I Trauma coding, Preferred.

• Good oral and written communication skills and comprehensive knowledge of the MS_DRG structure and regulatory requirements.
• Knowledge of 3M Encoder, Computer Assisted Coding (CAC) and Epic. Prior knowledge of PWC SMART Application, a plus.
• Extensive working knowledge of Medicare, Medicaid and Commercial Provider reimbursement methodologies to assist Patient Financial Services, when needed.
• Ability to research and resolve root causes of Claim Edits related to unbilled accounts.

Remote – 100%

Equal Opportunity Employer-Minorities/Females/Veterans/Individuals with