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Munson Healthcare · 5 days ago

Data Quality Senior Coder

United States

Full-time

Remote

Mid, Senior Level

2+ years exp

Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. The Data Quality Senior Coder is responsible for performing medical record coding and abstracting reviews, completing appeals processing tasks, and ensuring compliance with coding guidelines.

Hospital & Health Care

Responsibilities

The Data Quality (DQ) Senior Coder performs medical record coding and abstracting reviews with expert knowledge of ICD-10-CM, ICD-10-PCS and CPT-4 classification systems

The DQ Senior Coder also completes appeals processing tasks for both the inpatient and outpatient Data Quality Appeal Teams

In all responsibilities, adheres to the Official Guidelines for Coding and Reporting, AHIMA Code of Ethics “Standards of Ethical Coding”, AHA Coding Clinic and technical rules outlined by hospital guidelines

Supports the mission statement of Munson Medical Center (MMC): Munson Medical Center is the core of a regional health system

In partnership with physicians, we provide quality, compassionate, comprehensive and cost-effective services for improvement of the health of our patients and the communities we serve

Embraces and support the Continuous Quality Improvement (CQI) philosophy of Munson Medical Center: We are committed to the name “Munson” meaning excellence

We will provide services that meet our customers’ requirements every time

Reviews and abstracts information from auditor denials to communication sheets

Forwards relevant documentation to nurses for appeal consideration or analysts for further review or action for coding errors

Processes appeals sent in the C360 system in an accurate and timely manner

Files appeals and maintains organized records for tracking and compliance

Writes E/M appeals to support accurate reimbursement

Logs and processes lost/won appeals to ensure proper follow-up and resolution

Reviews and responds to coding denial QUICs for both inpatient and outpatient teams

Escalates as needed to analysts for additional review/code correction

Collaborates intra and interdepartmentally to resolve discrepancies and ensure proper coding

Assists with outpatient coding reviews as needed to ensure accuracy and compliance with guidelines

Works closely with nurses, analysts, and DQ team members to process denials and appeals and resolves issues

Ability to accurately code and abstract medical records using ICD-10-CM diagnosis, ICD-10-PCS, and CPT-4 procedure codes

Meets productivity standards as defined by the department

Participates in ongoing education and training to maintain coding certifications and stays current with industry changes

Assists with special projects, audits, and other tasks assigned by leadership

Qualification

ICD-10-CMICD-10-PCSCPT-4CCS certificationRHIT certificationRHIA certificationMedical coding experienceTeam collaborationCommunication skillsAttention to detail

Required

Associate's or Bachelor's degree in Health Information, or CCS certification with a minimum of 2 years coding experience will be considered

Certification as a Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS) with two years' coding experience is required

The ideal candidate will possess both inpatient and outpatient medical record coding experience