What are the responsibilities and job description for the Pre-Bill Coder Specialist - Inpatient position at Aurora Health Care?
- Prioritizes and codes and abstracts high dollar charts, day after discharge, as well as interim charts, at regular intervals, with a high degree of accuracy.
- Reviews complex medical documentation at a highly skilled and proficient level from clinicians, qualified health professionals and hospitals to assign diagnosis and procedure codes utilizing ICD CM/PCS, CPT, and HCPCS.
- Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software. Assigns codes for present on admission, research, Hospital acquired Conditions and Core Measure Indicators for all diagnoses both concurrently and post-discharge.
- Collaborates with other departments to clarify pre-bill coding documentation issues such for inpatient and outpatient to insure reimbursement and clinical outcomes.
- Works claim edits for all patient types and may codes consecutive/combined accounts to comply with the 72-hour rule and other account combine scenarios.
- Completes informal peer-review on inpatient and outpatient coders.
- Tracks and trends quality information from internal and external sources to partner with the educational team on opportunities.
- Communicates with Medical Staff, CDI, Post -bill for documentation clarification.
- Utilizes EMR communication tools to track missing documentation on inpatient queries that require follow-up to facilitate coding in a timely fashion. Partners with HIM, Patient Accounts, and Integrity, when needed, to help resolve issues affecting reimbursement and outcomes.
- Maintains current knowledge of changes in Inpatient coding and reimbursement guidelines and regulations as well as new applications or settings for coding all types of patients.
- Must be able to use critical decision-making skills to determine when to query to clarify documentation independently for outcomes, reimbursement and benchmarking.
- Must have a certification through American Health Information Management Association (AHIMA) or American Academy of professional Coders (AAPC)
- Two Year associate degree or equivalent work experience
- Five to Seven years of inpatient coding experience in an acute care inpatient setting in an Academic Inpatient Care Tertiary Facility
- Advanced proficiency of ICD, CPT and HCPCS coding guidelines. Advanced knowledge of medical terminology, anatomy and physiology.
- Excellent computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications.
- Excellent communication (oral and written) and interpersonal skills.
- Excellent organization, prioritization, and reading comprehension skills.
- Excellent analytical skills, with a high attention to detail.
- Ability to work independently and exercise independent judgment and decision making.
- Ability to meet deadlines while working in a fast-paced environment.
- Ability to take initiative and work collaboratively with others.
- Exposed to a normal office environment.
- Must be able to sit for extended periods of time.
- Must be able to continuously concentrate.
- Position may be required to travel to other sites; therefore, may be exposed to road and weather hazards.
- Operates all equipment necessary to perform the job.
- This job description indicates the general nature and level of work expected of the incumbent. It is not designed
- to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
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Salary : $29 - $43