Inpatient Coder II

Summary

Join Northwestern Medicine as an Inpatient Coder II and become a coding and reimbursement expert for complex inpatient acute care discharges. You will utilize your expertise in ICD-10-CM and ICD-10-PCS coding, clinical disease processes, and medical terminology to assign appropriate codes and ensure accurate reimbursement. This role requires collaboration with the Clinical Documentation Improvement (CDI) department and involves interpreting health record documentation, resolving coding issues, and meeting productivity standards. Northwestern Medicine offers competitive benefits, including tuition reimbursement, loan forgiveness, 401(k) matching, and lifecycle benefits. Must reside in IL, IN, IA, or WI.

Requirements

• Reside in IL, IN, IA, or WI
• Reflect the mission, vision, and values of NM, adhere to the organization’s Code of Ethics and Corporate Compliance Program, and comply with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards
• 3 years of inpatient coding experience in an acute healthcare setting
• RHIA, RHIT or CCS credential
• AHIMA membership

Responsibilities

• Utilize technical coding expertise to assign appropriate ICD-10-CM and ICD-10-PCS codes to complex inpatient visit types
• Utilize expertise in clinical disease process and documentation, to assign Present on Admission (POA) values to all secondary diagnoses for quality metrics and reporting
• Thoroughly review the provider notes within the health record and the Findings from the Clinical Documentation Nurse in the Clinical Documentation Improvement (CDI) Department who concurrently reviewed the record and provide their clinical insight on the diagnoses
• Utilize resources within CAC (Computerized Assisted Coding) software to efficiently review documentation and select or assign ICD-10-CM/PCS codes using autosuggestion or annotation features
• Review Discharge Planning and nursing documentation to validate and correct when necessary, the Discharge Disposition which impacts reimbursement under Medicare’s Post-Acute Transfer Policy
• Utilize knowledge of MS-DRG’s, APR-DRG’s, AHRQ Elixhauser risk adjustment to sequence the appropriate ICD-10-CM codes within the top 24 fields to ensure correct reimbursement and NM’s ranking in US News and World Report
• Collaborate with CDI on approximately 45% of discharges regarding the final MS or APR DRG and comorbidity diagnoses
• Educate CDI on regulatory guidelines, Coding Clinics and conventions to report appropriate ICD-10-CM diagnoses
• Interpret health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, medical terminology to determine the Principal Diagnosis, secondary diagnoses and procedures
• Follow the ICD-10-CM Official Guidelines for Coding and Reporting, ICD-10-PCS Official Guidelines for Coding and Reporting , Coding Clinic for ICD-10-CM and ICD-10-PCS, coding conventions and instructional notes to assign the appropriate diagnoses and procedures
• Utilize coding expertise and knowledge to write appeal letters in response to payor DRG downgrade notices
• Resolve Nosology Messages/Alerts and Coding Validation Warning/Errors
• Meet established coding productivity and quality standards

Preferred Qualifications

• Associate’s degree in related field
• RHIA, RHIT with CCS or CDIP/CCDS credential
• 4 years of inpatient coding experience in a teaching hospital

Benefits

• Tuition reimbursement
• Loan forgiveness
• 401(k) matching
• Lifecycle benefits