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Valley Medical Center · 1 day ago

Coder/Abstractor III (Remote, WA residents only) (2025-1049)

United States

Full-time

Remote

Mid Level

$29.12/hr - $48.67/hr

3+ years exp

Valley Medical Center is seeking a Coder/Abstractor III responsible for hospital inpatient coding and abstracting based on documentation and coding guidelines. The role involves resolving coding-related edits and denials while providing ongoing feedback and education to physicians and clinicians.

Hospital & Health Care

Responsibilities

Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, leading to the assignment of the correct Medicare Severity-Diagnosis Related Group, (MS-DRG) or All Patient Refined Diagnosis Related Group, (APR-DRG)

Responsible for final coding and DRG accuracy on all inpatient accounts

Maintains confidentiality of protected health information

Reviews coding-based edits, corrects errors, and educates clinic and medical staff on appropriate use of ICD-10-CM and ICD-10-PCS codes

Demonstrate advanced competency with ICD-10-CM and ICD-10-PCS code assignment for diagnoses and procedures for hospital requirements

Collaborates with Clinical Documentation Specialists, HIM deficiency team, and members of the medical staff to ensure completeness of documentation in the charts so that appropriate codes, and ultimately the correct Diagnosis Related Group (DRG,) may be assigned

Codes all records based on documentation, being careful to follow strict coding guidelines, payer regulations, and ethics

Ensure compliance with all Federal and State guidelines regarding correct coding initiatives

Meets productivity coding standards as outlined in the productivity policy

Participates in coding meetings to enhance knowledge and coding compliance skills

Communicates effectively with Revenue Cycle team and hospital departments in relationship to coding or charging concerns and the submission of claims

Reviews coding-based payment denials, identifies patterns, corrects errors, and educates clinic and revenue cycle staff on appropriate coding procedures when services are denied due to inappropriate diagnosis or procedure coding

Provides immediate telephone support to clinic, medical, and revenue cycle staff who have coding questions

Assists with new provider orientation on VMC's coding, audit process and documentation standards

Apprises management of concerns as appropriate, including backlogs and time available for additional tasks

As necessary, negotiates a work improvement plan with management to raise work quality and quantity to standards

Maintains appropriate CEU's annually as required for certification

Adheres to policies and procedures as required by VMC

Performs all job functions in a manner consistent with Valley's expectations as defined in Valley Values

Completes additional projects and duties as assigned

Qualification

Inpatient hospital codingICD-10-CM codingICD-10-PCS codingRHIA certificationRHIT certificationCCS certificationDRGMedical terminologyCustomer service skillsData entry skillsAttention to detailOrganizational skillsEffective communication

Required

Associate or bachelor's degree in HIM, required

RHIA, RHIT, or CCS required

3 or more years exclusively in inpatient hospital coding experience, required

Demonstrated advanced ability to use and understand DRG, ICD-10-CM, and ICD-10-PCS coding methodologies

Advanced knowledge of anatomy, physiology, pharmacology, disease processes and medical terminology

Ability to communicate in writing and verbally in the English language in an effective manner. Effective communication includes ability to spell accurately and write legibly

Ability to research authoritative citations related to coding, compliance, and additional reporting needs

Ability to carry out assignments independently, follow procedures, and exercise good judgment

Excellent customer service skills, including telephone interactions

Proficient data entry skills

Proven ability to interact with physicians and support staff

Attention To Detail And Excellent Organizational Skills Are Essential

Knowledge of Medicare, Medicaid, and third-party coding and billing requirements

Successful completion or pre-hire coding test