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Inpatient Coding Resolution Specialist Jobs in Indiana

Methodist Hospitals

CODING AUDITOR

Merrillville, IN

$26.75 - $30.50/hr

Performs comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient ... Prior history as Clinical Documentation Specialist role, leadership skills, helpful. * Demonstrates ...

Methodist Hospitals

CODING AUDITOR

Merrillville, IN · On-site

$26.75 - $30.50/hr

Performs comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient ... Prior history as Clinical Documentation Specialist role, leadership skills, helpful. * Demonstrates ...

Methodist Hospitals

CODING AUDITOR

Merrillville, IN

$26.75 - $30.50/hr

Performs comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient ... Prior history as Clinical Documentation Specialist role, leadership skills, helpful. * Demonstrates ...

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Inpatient Coding Resolution Specialist information

What are some common challenges faced by Inpatient Coding Resolution Specialists, and how are they typically addressed?

Inpatient Coding Resolution Specialists often encounter challenges such as interpreting complex medical records, keeping up with frequent coding updates, and resolving discrepancies between clinical documentation and coding guidelines. To address these, specialists regularly collaborate with physicians and clinical staff to clarify documentation, participate in ongoing training to stay current with coding standards (like ICD-10 and DRG classifications), and utilize coding software to ensure accuracy. Effective communication and strong attention to detail are essential for successfully navigating these challenges within a hospital or healthcare system setting.

What is the difference between Inpatient Coding Resolution Specialist vs Medical Coder?

AspectInpatient Coding Resolution SpecialistMedical Coder
CertificationsAHIMA or AAPC credentials, coding certificationsSimilar certifications, often AHIMA or AAPC
Work EnvironmentHospitals, inpatient facilities, coding departmentsClinics, outpatient facilities, various healthcare settings
Job FocusResolving inpatient coding discrepancies, ensuring accurate DRG assignmentGeneral coding tasks across inpatient and outpatient records
Employer & Industry UsageHospitals, health systems, inpatient coding teamsMedical practices, outpatient clinics, coding companies

The Inpatient Coding Resolution Specialist primarily focuses on resolving inpatient coding issues, ensuring accurate DRG assignments, and working within hospital settings. In contrast, Medical Coders handle a broader range of coding tasks across inpatient and outpatient records. Both roles require similar certifications and often work in healthcare environments that demand precise coding skills, but their specific responsibilities and work settings differ.

What are Inpatient Coding Resolution Specialists?

Inpatient Coding Resolution Specialists are healthcare professionals who review, analyze, and resolve discrepancies or issues in medical coding for inpatient hospital stays. They ensure that diagnoses, procedures, and services are accurately coded according to regulatory and payer requirements, which helps maximize reimbursement and maintain compliance. These specialists often collaborate with physicians, clinical staff, and other coding professionals to clarify documentation and resolve coding denials or audits. Their expertise is crucial for the financial health of healthcare organizations and for maintaining accurate patient records.

What are the key skills and qualifications needed to thrive as an Inpatient Coding Resolution Specialist, and why are they important?

To excel as an Inpatient Coding Resolution Specialist, you need a solid understanding of medical terminology, ICD-10-CM/PCS coding systems, and healthcare reimbursement methodologies, often backed by a certification such as CCS or RHIA/RHIT. Familiarity with electronic health record (EHR) systems, coding software, and compliance tools is crucial for accurate data entry and audit processes. Strong analytical thinking, attention to detail, and effective communication skills distinguish top performers in this role. These skills are vital to ensure coding accuracy, regulatory compliance, and optimal reimbursement for healthcare organizations.
What are popular job titles related to Inpatient Coding Resolution Specialist jobs in Indiana? For Inpatient Coding Resolution Specialist jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Inpatient Coding Resolution Specialist jobs in Indiana look for? The top searched job categories for Inpatient Coding Resolution Specialist jobs in Indiana are:
What cities in Indiana are hiring for Inpatient Coding Resolution Specialist jobs? Cities in Indiana with the most Inpatient Coding Resolution Specialist job openings:
Inpatient Coding Resolution Specialist jobs near you
CODING AUDITOR

CODING AUDITOR

Methodist Hospitals

Merrillville, IN

$26.75 - $30.50/hr

Other

Posted 21 days ago

Job description

Overview

Responsible for ensuring accuracy and quality coding assignments for all records requiring DRG and/or APC coding; ensures optimal and timely reimbursement.

Responsibilities

Principal Duties and Responsibilities (*Essential Functions)

  • Performs comprehensive pre-billing coding audits, through the use of eValuator, to ensure claims are accurately coded and charged in compliance with coding and regulatory standards.

  • Performs comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient records to ensure proper coding guidelines have been followed and appropriate DRG (MS/APR) or APC assignments have been made for appropriate reimbursement.

  • Responsible for completion of reviews within 72 hrs of import date to include new reviews of up to or exceeding 12 to 15 per day for inpatients and/or completion of reviews within 48 hrs of import date including up to or exceeding 50 per day for outpatient accounts.

  • Maintains an audit response turnaround time of 24 to 48 hours, with the exception of weekends.

  • Reviews abstracted data to ensure quality of required data elements (facility specific elements) including appropriate discharge disposition.

  • Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient and/or inpatient records.

  • Serves as a subject matter expert on ICD 10-CM/PCS and/or CPT/HCPCS coding guidelines and policies.

  • Coaches and educates coding staff to ensure staff adheres to ICD 10-CM/PCS, CPT/HCPCS coding guidelines and policies.

  • Maintains working knowledge of CMS (Medicare and Medicaid) regulations, Local Coverage Determinations (LCD), National Coverage determination (NCD) and National Correct Coding Initiatives (NCCI).

  • Communicates quality audit results and recommendations to management in a clear and concise manner

  • Performs ad hoc quality reviews and audits as requested by management.

  • Participates in team meetings with coding staff to discuss coding problems, changes, or issues.

  • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and monitors coding staff for violations and reports to leadership when areas of concern are identified
  • Performs other duties as needed and/or assigned.
    • Qualifications

    Job Specific (Minimum Requirements)

    Knowledge, Skills, and Abilities

    • Demonstrates working knowledge of the English language, verbal and written.
    • Prior history as Clinical Documentation Specialist role, leadership skills, helpful.
    • Demonstrates basic understanding of coding guidelines.
    • Requires course work in/knowledge of medical terminology, anatomy and physiology, pathophysiology in order to interpret data on patient documentation. Working knowledge of all areas of adult medicine.
    • Demonstrates strong interpersonal and communication skills necessary to interact effectively with all internal and external customers, verbally and in writing, as required.
    • Requires strong organizational and analytical skills in order to prepare and maintain various documentation/reports.
    • Demonstrates the knowledge and understanding of intensity of service, severity of illness, opportunities for intervention, planned course of treatment/procedures, care needs, and outcome goals.
    • Requires excellent observation skills, analytical thinking, and problem solving ability.Requires strong critical thinking skills, ability to assess/evaluate/teach.

    Education

    Associates Degree in Health Information Technology is Required.

    Bachelors Degree in Health Information Technology is Preferred.

    Experience

    Inpatient Coding/Clinical documentation review is Preferred.

    3 yrs of Coding/Clinical documentation Improvement is Preferred.          

    Certifications and Licensures                     

    RHIT/RHIA certification is Required.

    Model of Care and Conduct

    Methodist Hospitals strives for excellence and insists on high standards of conduct and performance in everything we do. Our Model of Care and Conduct is designed to create a positive work environment which Methodist desires for all employees. This is foundational to the high level of patient, family and physician satisfaction we strive for each day. As part of all position's duties at Methodist Hospitals, all employees are responsible to conduct themselves in accordance with the Model of Care and Conduct and will be evaluated according to these standards of behavior.

    Employment Type: OTHER
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    About Methodist Hospitals

    Sourced by ZipRecruiter

    Methodist Hospitals is a reputable institution in the healthcare and medical industry with its base in Gary, Indiana, United States. A trusted name in comprehensive medical services, the organization is primarily known for its robust offering in the fields of emergency and acute medical care, tracking back its foundational roots to the year 1923. Catholic nun Sister Gesuina set up the hospital with the sole mission of providing affordable healthcare services to the residents of Gary. Today, their mission stays true to promoting health, healing, and well-being in the communities they serve, encompassing a diverse representation of races, ethnicities, genders, ages, religions, abilities, and sexual orientations.

    Industry

    Health care and social assistance

    Company size

    1,001 - 5,000 Employees

    Headquarters location

    Gary, IN, US

    Year founded

    1923

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