HIM Coder Analyst III

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Summary:

The HIM Coder Analyst III requires extensive knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets, along with Medicare/Medicaid rules and guidelines. The role involves reviewing and interpreting patient medical records to identify diagnoses and procedures, and assigning ICD-9-CM, ICD-10-CM/PCS, and CPT 4 codes accurately and promptly, based on physician documentation for inpatient, observation, and outpatient records. The coder validates data against Diagnosis Related Groupers (DRGs), checks Present on Admission (POA) indicators, and codes complex inpatient records. Responsibilities include abstracting information, entering data into the electronic health record system, and performing extended length of stay coding for billing. The role also involves reviewing documentation opportunities during in-house coding, querying clinicians for clarification, and coding outpatient visits as needed. The minimum accuracy rate for coding and DRG assignment is 95%. Communication with physicians and collaboration with documentation and quality teams are essential to ensure accurate documentation and coding. The role requires staying current with coding regulations and guidelines.

Education & Experience:

• RHIA, RHIT required; CCS highly desired, or CCS with at least two years of hospital inpatient ICD-10-CM/PCS coding and DRG experience.
• Experience with outpatient observation, ambulatory surgery CPT-4 coding, and pediatric coding is highly desirable.
• Proficiency in electronic health records, encoders, and software applications is required.
• Experience with Microsoft Office Excel and Word is preferred.
• Ability to work independently, with strong attention to detail, organization, and communication skills.
• Maintaining confidentiality and demonstrating critical thinking are essential.
• Coding proficiency must be validated through an on-site skills assessment with at least 90% accuracy prior to hire.

Certification/Licensure:

• RHIA, RHIT, or CCS certification required. Candidates must provide current AHIMA continuing education records.

About Us:

Cook Children's Medical Center offers advanced technology, research, treatments, surgery, and rehabilitation services designed to meet children's needs. Cook Children's is an EOE/AA employer supporting minorities, females, individuals with disabilities, and veterans.