HIM Inpatient Coding Specialist II

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

HIM Inpatient Coding Specialist II

Job Summary:

Performs all coding and abstracting for Penn Medicine by reviewing medical records and selecting the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures accurately. Performs analysis of the DRG assigned to produce the highest level of reimbursement to which the facility is legally entitled according to stringent coding and compliance guidelines. Reviews and acts as the gatekeeper for the provider query process, by being the single point of contact with the provider community. Assist the Revenue Cycle Manager by completing the preliminary DRG report for Finance, and compiling additional reports as needed to demonstrate where HIM is in meeting their weekly DNFB goals.

Responsibilities:

Examines the complete medical record to accurately determine the principal & secondary diagnoses, procedures, co-morbidities and complications demonstrating 96% accuracy as determined by audits.

Sequence the diagnoses & procedures to obtain the optimal DRG or APR-DRG assignment and demonstrates 96% accuracy as determined by monthly audits.

Demonstrate 95% accuracy for secondary diagnosis coding

Simultaneously abstracts and enters all coded information into the Epic system for timely billing. This includes the correct discharge disposition verified through the workflow located in Epic.

Demonstrates a consistent level of performance; strives to maintain a steady level of productivity according to the following guidelines:

HUP & PPMC

Average of 15 inpatient records coded daily

PAH, CCH, and Princeton

Average of 19 inpatient records coded daily

Process retrospective queries at any facility. Productivity standard of 22 per day

Must possess the ability to code all facilities while maintain the accuracy and productivity standards sets above

Refers charts that require clarification of vague or unclear documentation for accurate coding and DRG assignment to a Coding Quality Specialist to query the physician for the needed documentation.

Promptly and accurately assigns Coding Hold reasons to all records that cannot be completed immediately due to:

Missing Operative Notes

Missing Pathology Report

Physician Query Needed

Mortality Review

Discharge Disposition

Missing Other Reports (Card Cath, EPS, etc)

Is willing to adjust schedule to complete workload and meet pivotal revenue cycle deadlines when requested by management. Cooperates with departmental work volumes by adjusting work schedule.

Correctly identifies and applies Present on Admission indicators to all applicable diagnoses according to designated guidelines. Accuracy is important due to the far-reaching impact on reimbursement and quality metrics.

Consistently codes the oldest cases first and prioritizes high dollar cases over 4 days old first.

Strives to become fluent in the inpatient coding at all of the UPHS facilities.

Performs revenue cycle/DNFB activities as needed.

Reviews and processes provider queries. This includes working with the coding staff to appropriately write the query as well as communicating with the provider community to ensure the query is answered.

Responsible for continuing education both inside and outside the organization along with tracking Continuing Education credits to maintain professional credentials.

Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.

Other duties as assigned to support the unit, department, entity, and health system organization.

Credentials:

Certified Coding Specialist-CCS (AHIMA) (Required)

RHIA or RHIT (Preferred).

Education or Equivalent Experience:

H.S. Diploma/GED (Required)

1+ years of experience coding inpatient medical records (Required)

Bachelor of Arts or Science, Health Information Management or related field (Preferred)

Skills & Abilities:

Demonstrated ability to code at each of the three facilities (HUP, PPMC, PAH) while maintaining the appropriate accuracy and production levels (applies to internal applicants only)

Extensive knowledge of medical terminology, human anatomy and physiology, and clinical disease processes

Extensive knowledge of ICD-10-CM and ICD-10-PCS

Ability to assess, prioritize and complete multiple tasks in a stressful environment

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

REQNUMBER: 236827