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The Inpatient Medical Coder - Skilled Nursing Facility will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 and PCS Diagnosis codes as defined for short term rehabilitation, long term resident and hospice patient accounts. 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. Must have knowledge of PDPM clinical categories for correct principal diagnosis assignment. Must have extensive knowledge of ICS-10 PCS codes to accurately describe all therapy services. Must have knowledge of query submission proceses and medical necessity coverage articles. This is a 100% full time remote position.
Maintains a working knowledge of ICD-9-10 PCS and CPT coding principles, 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.
Maintains average productivity standards as follows: 3 IP charts per hour (These productivity standards are Navigant general expectations and are subject to change based upon Navigant 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).
Follows facility specific policies and procedures.
Works pending queues daily.
Works NavAudit review queue daily to ensure all charts that are placed 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
Reports downtime immediately to the administrative staff to ensure turnaround is met.
Works 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.
Codes current or pending placed in their queue within 24 hours.
Notifies 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.
Ensures communication in emails is always be professional (reference e-mail policy).
Clocks in and out of ADP during work shift and enters billing hours into NavCentral People Soft to ensure all employee hours are correct and ensure the correct task codes have been used.
Works closely with client IT departments and Navigant IT to resolve system issues.
Reviews and updates Client Portal, and using the information contained on the Portal as a daily tool to correctly code and abstract for each facility.
Checks email system at least every two hours during work hours.
Maintains current professional credentials.
Maintains a working knowledge of all Coding Clinic Guidelines.
Completes CE education provided by Navigant and turns in certificates timely.
Maintains HIPAA compliant work stations (reference HIPAA work station policy).
Maintains patient privacy always (reference company handbook poli
Minimum 3-5 years+ previous work experience coding hospital acute care Inpatient records.
CCS, RHIA or RHIT Certification Required.
Must have previous rehabilitation and/or long term skilled nursing medical coding experience
Must have experience working in systems such as EPIC, Cerner, Next Gen, Allscripts or other EHR.
Must show personal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service.
Must be computer literate.
Must have good working knowledge of Anatomy and Physiology as well as Medical Terminology.
Must have advanced knowledge of Coding clinics ICD-10-CM and PCS.
Has ability to analyze Provider documentation and assign codes accurately.
Shows excellent verbal and written communication Skills.
Strong knowledge and application of Government and other payer guidelines as they relate to compliant coding.
High level of Accuracy and Productivity. Meets or exceeds standards consistently.
Ability to work independently.
Must have HIPAA compliant work stations.
Strong working knowledge of Protected Health Information.
Maintains professional credentials at all times.
Strong organizational Skills.
Knowledge of Microsoft Word and Excel.
Demonstrates the ability to perform quality coding on ancillary charts, clinic charts, and emergency room records.
The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.
Candidates from Eastern Standard Time, Central Standard Time, and Pacific Standard Time Zones as well as candidates from Arizona, New Mexico and Utah will be considered for this position.
Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at ~~~ or via email at ~~~ . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
Rewards and Benefits
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Parental Leave and Adoption Assistance
401(k) Retirement Plan
Basic Life & Voluntary Life Insurance
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Position may be eligible for a discretionary variable incentive