Summary:

The senior coding specialist reports to the Manager of Hospital Coding for Brown University Health Corporate Services. Under general supervision and within Hospital and departmental policy the senior inpatient coding specialist reviews inpatient clinical documentation to extract data and assign appropriate codes in accordance with the inpatient ICD-10 CM/PCS Official Guidelines for Coding and Reporting of various inpatient scenarios covering multiple disciplinary service lines including complex long stay and high dollar balance cases throughout all Brown University Health affiliates.Determines appropriate code assignment for optimal code classification for accurate and compliant clinical data reporting standards.

Responsibilities:

Reviews inpatient medical records covering multiple disciplinary service lines to

accurately

identify

all treated diagnos

e

s and

procedures performed reporting the correct ICD-10 CM/PCS code(s)

in accordance with official coding guidelines

. Enters all coded/abstracted information utilizing the 3M 360 Encompass system to ensure accurate MS-DRG or APR-DRG assignment

.

Ensures the medical record documentation supports the codes selected for the principal diagnosis secondary diagnoses complications co-morbid conditions procedures and discharge disposition. Understands clinical documentation to recognize when a query to the physician is required.

Works collaboratively with the Clinical Documentation Integrity team.

Identifies and recommends physician queries when documentation in chart is incomplete ambiguous or unclear.

Maintains coding accuracy and productivity standards. Follows up on all bill holds/deferred claims to ensure timely billing and reimbursement.

Reviews and processes any coding validation /auditing review recommendations in a timely manner.

Actively participates in team meetings to enhance functional excellence. Good writing skills to prepare compliant physician queries.

Abides by the �Standards of Ethical Coding� as set forth by the American Health Information Management Association.

Other information:

EDUCATION/ BASIC KNOWLEDGE:

Associate degree in health information technology and/or successful completion of coding certification program or commensurate work experience in a related healthcare field. Coding certification required from the American Health Information Management Association (AHIMA (preferred) [RHIA RHIT CCA CCS or CCS-P] or the American Academy of Professional Coders (AAPC) [CPC or CPC-H] with intent to acquire inpatient coding credential. Maintenance of coding professional credentials/competencies required through internal and external educational opportunities.

Ability to recognize and understand clinical documentation criteria pertinent for coding including clinical indicators risk factors and treatments for diagnoses.

Trained in medical terminology medical science disease processes anatomy and physiology.

Computer literate: capable of researching websites to access regulatory requirements.

Ability to navigate the patient electronic medical record.

Strong writing organizational and communication skills required.

EXPERIENCE:

3-5 years of experience in a coding related field. Working knowledge of EMR system knowledge of MS-DRG and APR-DRG reimbursement systems ICD-10 CM/PCS CPT and HCPCS guidelines.

WORKING CONDITIONS:

Requires long periods of sitting to review medical records. Ability to work under stressful conditions to maintain accounts receivable days achieving productivity and accuracy.

On site office or home office environment.

All staff working remotely must adhere by theFlexible Work ArrangementsPolicy and follow the Flexible Work Arrangements Guidelines and Forms instructions.

INDEPENDENT ACTION:

Performs independently within the department�s policies and practices. Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required.

SUPERVISORY RESPONSIBILITY:

None

Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor.

Location: Brown University Health Corporate Services USA:RI:Providence

Work Type: Full Time

Shift: Shift 4

Union: Non-Union