• Evaluates health record documentation and accurate reimbursement by ensuring that ICD-10-CM diagnostic and PCS procedural codes accurately reflect and support the inpatient hospital admission

• Identifies documentation clarification opportunities to ensure that documentation supports the coding and DRG assignment. Initiates coding queries and provides feedback to clinicians

• Reviews Local Coverage Determination (LCD)/National Coverage Determination (NCD) policies for ICD-10-CM diagnoses that support medical necessity for services provided

• Works with the coding denials team for education and assists with DRG denial prevention solutions

• Ensures inpatient accounts are coded accurately and in a timely manner

• Consistently maintains coding quality (95% accuracy) and productivity expectations

• Assists with the training of inpatient coders

• Performs related duties as required

Educational Requirements:

• Successful completion of a coding program, which included coursework in ICD-10-CM/PCS, medical terminology, anatomy and physiology and disease processes

Required Qualifications:

• Two (2) years of hospital inpatient/DRG coding experience

• Passing score on the Essentia Health senior inpatient coding skills assessment

Preferred Qualifications:

• Epic experience

• 3M Encoder experience

• Computer Assisted Coding experience