Inpatient Pediatric Medical Coder

Job Family:

General Coding

Travel Required:

None

Clearance Required:

None

What You Will Do:

The Inpatient Pediatric Medical Coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and CPT Diagnosis codes, as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS and any other official coding guidelines established for use with mandated standard code sets. This position is full-time and 100% remote.

Duties and Responsibilities:

• Demonstrates the ability to perform quality hospital coding on Inpatient pediatric accounts including Medicare/NonMedicare, Surgical, Medical, Cardiac, moms/babies, and trauma cases.
• Maintains a working knowledge of ICD-10 PCS, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing.
• Assures that all services documented in the patient’s chart are coded with appropriate ICD-10/PCS codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards.
• Achieves and maintains 95% accuracy in coding while maintaining a high level of productivity.
• Ability to maintain average productivity standards as follows: 2 IP charts per hour (These productivity standards are Guidehouse general expectations and are subject to change based upon Guidehouse client agreements and/or other factors as determined by management. Notification of expected productivity will be conveyed by Management prior to assignment of a client project).
• Responsible for following facility specific policies and procedures
• Works pending queues daily.
• Works GuideAudit review queue daily to ensure all charts in the review queue are worked and any corrections are communicated to the facility.
• Queries physicians whenever there is conflicting, ambiguous, or incomplete information in the medical record regarding any significant reportable condition or procedure.
• Follows facility query policy and CDI reconciliation process.
• Charts that require re-bills are corrected and communicated to the facility daily for the re- bill process. See re-bill policy in facility guidelines.
• Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met.
• Work directly with the IQC staff to ensure quality standards are being met for each facility.
• Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request.
• Responsible for coding or pending every chart placed in their queue within 24 hours.
• It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard.
• Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services.
• Communicates problems or coding principle discrepancies to their supervisor immediately.
• Communication in emails should always be professional (reference e-mail policy).
• Clocks in and out of ADP during work shift and enters billing hours into People Soft to ensure all employee hours are correct and ensure the correct task codes have been used.
• Collaborate closely with client IT departments and Guidehouse IT to resolve system issues.
• Responsible reviewing and updating Client Portal, and using the information contained on the Portal as a daily tool to correctly code and abstract for each facility.
• Check email system at least every two hours during work hours.
• Communication in emails should always be professional (reference e-mail policy).
• Must maintain current professional credentials.
• Coder is to maintain a working knowledge of all Coding Clinic Guidelines.
• Complete CE education provided by Guidehouse and turns in certificates timely.
• Maintain HIPAA compliant workstations (reference HIPAA workstation policy)
• Maintain patient privacy always (reference company handbook policy compliance section 105)
• Abide by all client policies and procedures.
• Abide by all Guidehouse policies and procedures.