Coder

The Coder reviews patient records and assigns codes (ICD-10-CM, ICD-10-PCS, CPT, HCPCS) for each diagnosis and procedure. The coder applies knowledge of medical terminology, disease processes and pharmacology to ensure these codes accurately reflects the care provided to each patient.

Responsibilities:

• Accurately assigns and sequences codes (ICD-10-CM, ICD-10-PCS, CPT, HCPCS) for each patient encounter, following proper coding guidelines and legal requirements to ensure compliance with federal and state regulations
• Abstracts required medical record information from patient records
• Ensures correct DRG’s, APR DRG’s, and APC’s are calculated
• Queries providers when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes
• Assigns and enters charges such as E&M levels, infusion/injections, observation hours, etc.
• Participate in continuing education activities to expand coding skills and stay abreast of changes in coding guidelines and reimbursement reporting requirements
• Foster positive working relationships with CDI, billing, and other pertinent positions at DRH Health
• Identifies and reports discrepancies, potential quality concerns, and billing issues
• Reviews records to insure documentation in the record supports ordered services and meets medical necessity
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Association and adheres to official coding guidelines
• Must adhere to safety protocols at all times, including (position specific examples)
• Implement DRH Standards of Behavior and exhibit behaviors consistent with DRH core values.
• Performs other related duties as assigned by the department Director

Shift: 1

Hours: Monday-Friday, 80 hrs pp

Type: Full Time

Category: Non Clinical

Bachelors or associates degree in Health Information Management is preferred. Prefer at least 3 years experience in DRG and/or APC assignment. RHIA or RHIT preferred.  CCS or CPC preferred. Previous work experience as a coder or strong training background in coding and reimbursement. Outstanding communication and interpersonal abilities.

*Non-Safety Sensitive

**As a condition of employment, vaccinations are required per DRH Policy. Medical and Religious Exemptions are available upon request.