Medical Coder IV, Health Information Management

• Codes the correct principal/primary diagnosis consistent with established coding guidelines (95% or greater accuracy).
• Identifies all significant diagnoses (complications and co-morbidities/HCCs) relevant to the type of visit and assigned appropriate codes.
• Codes procedures as appropriate and identifies the principal procedure consistent with established coding guidelines.
• Ensures all conditions coded adequately reflect the appropriate clinical severity and grouping assignment in accordance with documentation.
• Follows official coding guidelines and directives and uses reference materials to ensure codes assigned are in compliance with state and federal regulations.
• Validates accounts for medical necessity based on local medical review policies (LMRPs), national coverage determinations (NCDs), or payer guidelines.
• Researches and validates claim edits and denials appropriately.
• Obtains clarification and/or collaborates with the Provider, Clinical Documentation Specialist, and/or Internal Coding Auditor to improve overall quality and completion of clinical documentation in patient records to ensure accurate and complete coding.
• Applies charge data as appropriate for services provided. Verifies level of service charged is supported by accompanying documentation.
• Completes coding consistent with established production standards for type of service.
• Verifies and corrects all abstract data captured.
• Assists with new hire and current staff training as well as student internship coding training.

• For hospital services – Codes for 3 or more specialty services (e.g. inpatient, emergency, home health, outpatient surgery, observation).
• For professional services - Codes 50% of more of time with specialty services (e.g. surgery, hematology/oncology, cardiology) or coordinates special projects/teams (e.g. provider newsletter, denials team).

• Knowledge of ICD-10-CM/PCS and CPT/HCPCS coding and medical necessity guidelines.
• Knowledge of various coding groupers used for various payers and types of encounters.
• Ability to read and interpret medical record documentation including laboratory and pharmacology data.
• Knowledge of Microsoft Office tools (excel, outlook, word).
• Strong computer background with basic typing and keyboarding skills.
• Work prioritization skills needed.
• Ability to concentrate on detailed tasks for long periods of time.
• Ability to work independently with frequent interruptions.
• Excellent interpersonal communication (verbal, non-verbal, and listening) skills and written communication skills.
• Knowledge of hospital payment systems and federal and state regulations related to billing, coding, and compliance.

• Five years previous coding experience required.

• Associate of Applied Science degree or Bachelor's degree in Health Information Technology or completion of coding certificate program required.

• AHIMA or AAPC coding certification (e.g. RHIT, RHIA, CCA, CCS, CCS-P, CPC) is required

Location: Mercy Medical Center - Cedar Rapids · Health Information Management
Schedule: Full Time, Day, flexible