Hospital Coding Specialist II (Remote) at Marshfield Clinic

Title: Hospital Coding Specialist II (Remote)

locations

Marshfield, WI

time type

Full time

job requisition id

R-0040187

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!

Job Title:

Hospital Coding Specialist II (Remote)

Cost Center:

101651098 HIM-Facility Coding

Scheduled Weekly Hours:

40

Employee Type:

Regular

Work Shift:

Mon-Fri; day shifts (United States of America)

Job Description:

JOB SUMMARY

Hospital Outpatient Coding:

The Hospital Coding Specialist ll reviews clinical documentation and diagnostic results as appropriate to extract data and apply appropriate International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes for billing, internal and external reporting, research and regulatory compliance activities. This individual accurately codes outpatient conditions and procedures as documented in the medical record and applying the ICD Official Guidelines for Coding and Reporting. The Hospital Coding Specialist II provides charge validation and capture processes for various patient types. This individual assigns codes for diagnoses, treatment, and procedures according to the appropriate classification system for outpatient encounters. The Hospital Coding Specialist II utilizes technical coding principles and APC reimbursement expertise to assign appropriate ICD diagnoses, ICD CPT/HCPCS codes including modifier assignment. This individual validates and/or identifies chargeable items for various patient types (i.e., OBS, SDS) and enters them into the billing system to include the following outpatient visit types:

• Ambulatory surgery (same day surgery), may include charge capture
• Observation service encounters
• Other hospital outpatient types in accordance with Coder II job descriptions, as assigned

Hospital Inpatient Coding:

The Hospital Coding Specialist II accurately codes inpatient conditions and procedures as documented in the International Classification of Diseases (ICD) Official Guidelines for Coding and Reporting and in the Uniform Hospital Discharge Data Set (UHDDS) and assignment of the appropriate MS-DRG (Medicare Severity-Diagnosis Related Group) or APR-DRG (All Patients Refined Diagnosis Related Groups) for complex, multi-specialty inpatient services. This individual understands and applies applicable medical terminology, anatomy and physiology, surgical technology, pharmacology and disease processes. The Hospital Coding Specialist II reviews professional and hospital inpatient medical record documentation and properly identifies and assigns:

• ICD CM and PCS codes for all reportable diagnoses and procedures. This includes determining the correct principal diagnosis, co-morbidities and complications, secondary conditions, surgical procedures and/or other procedures.
• MS-DRG /APR-DRG
• Present on admission indicators
• HAC (Hospital Acquired conditions) and when required, report through established procedures
• PSI conditions and report through established procedures
• Discharge Disposition code
• Works collaboratively with the Clinical Documentation Improvement Specialists to address documentation concerns and DRG assignments
• Assists in the preparation of responses to DRG validation requests and other third party payer inquiries related to coding and DRG assignments as requested

JOB QUALIFICATIONS

EDUCATION

The individual applying must meet the minimum qualifications in all three required sections below to be considered a candidate for interview. Please consider when listing minimum qualifications.

Minimum Required: Medical Coding Diploma or American Health Information Management Association (AHIMA) approved Health Information Management Degree or related program.

Preferred/Optional: None

EXPERIENCE

Minimum Required: Two years coding and reimbursement experience in a multi-specialty setting clinic/hospital or completion of coding degree or diploma will be considered in addition to the following:

• Knowledge of medical terminology, anatomy and physiology, pharmacology, disease process, and surgical procedures
• Knowledge of accepted medical abbreviations and their meanings
• Knowledge in the use of specialized references such as the ICD and CPT-4 books, medical dictionaries and texts, and medical journals
• Must have extensive knowledge of Coding Clinic, CPT Assistant and all official coding guidelines
• Advanced knowledge of hospital information systems, encoders and other technology to facilitate a successful work environment while maintaining maximum communication and adhering to HIPAA security standards
• Advanced knowledge Microsoft Outlook, Excel and Word functions
• Technical skills required to learn and navigate a variety of software systems and trouble shoot computer problems
• Strong written and verbal communication skills
• Ability to think and work independently, yet interact positively with team
• Advanced problem solving skills
• Attention to detail is crucial to this position

Preferred/Optional: Experience with electronic health record systems.

CERTIFICATIONS/LICENSES

The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position

Minimum Required: AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management) credential (i.e. CCS, CCS-P, RHIT, RHIA, CCA, CPC, CPC-H, COC) within one year of hire.

Preferred/Optional: AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management) credential (i.e. CCS, CCS-P, RHIT, RHIA, CCA, CPC, CPC-H, COC) at time of hire.

Given employment and/or payroll requirements of individual states, Marshfield Clinic Health System supports remote work in the following states:

Alabama

Alaska

Arkansas

Florida

Georgia

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Michigan

Minnesota

Mississippi

Missouri

Nebraska

North Carolina

North Dakota

Ohio

Oklahoma

South Carolina

South Dakota

Tennessee

Texas

Utah

West Virginia

Wisconsin

Wyoming

Marshfield Clinic Health System will not employ individuals living in states not listed above.

Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.

At Marshfield Clinic Health System, we are fully committed to addressing health equity, diversity and inclusion for our employees and providers, our patients, and the communities we serve. We believe that every individual should have the opportunity to attain their highest level of health. We embrace diversity and welcome differences in who we are and how we think. We believe that any individual or group should feel welcomed, respected and valued. View our Equity and Inclusion Statement here.

Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System’s Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.

Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.