Job Details

Summary: The senior coding specialist reports to the Manager of Hospital Coding for Brown University Health Corporate Services. Under general supervision and within hospital and departmental policies, the senior inpatient coding specialist reviews inpatient clinical documentation to extract data and assign appropriate codes in accordance with the inpatient ICD-10 CM/PCS Official Guidelines for Coding and Reporting. This role covers various inpatient scenarios across multiple disciplinary service lines, including complex long-stay and high-dollar balance cases throughout all Brown University Health affiliates. The specialist determines the appropriate code assignment for optimal classification, ensuring accurate and compliant clinical data reporting standards.Responsibilities:Reviews inpatient medical records across multiple disciplinary service lines to accurately identify all treated diagnoses and procedures, reporting the correct ICD-10 CM/PCS codes in accordance with official coding guidelines.Enters all coded/abstracted information utilizing the 3M 360 Encompass system to ensure accurate MS-DRG or APR-DRG assignment.Ensures that medical record documentation supports the codes selected for principal diagnosis, secondary diagnoses, complications, co-morbid conditions, procedures, and discharge disposition. Recognizes when a query to the physician is required based on clinical documentation.Works collaboratively with the Clinical Documentation Integrity team.Identifies and recommends physician queries when documentation is incomplete, ambiguous, or unclear.Maintains coding accuracy and productivity standards. Follows up on all bill holds/deferred claims to ensure timely billing and reimbursement.Reviews and processes coding validation/auditing review recommendations promptly.Participates actively in team meetings to enhance functional excellence. Prepares compliant physician queries with good writing skills.Adheres to the Standards of Ethical Coding as set forth by the American Health Information Management Association.Other Information:Education/Basic Knowledge:Associate degree in health information technology and/or successful completion of a coding certification program, or equivalent work experience in healthcare. Coding certification required from AHIMA (RHIA, RHIT, CCA, CCS, CCS-P) or AAPC (CPC, CPC-H), with the goal to acquire inpatient coding credentials. Maintenance of credentials through ongoing education.Ability to recognize and understand clinical documentation criteria relevant for coding, including clinical indicators, risk factors, and treatments.Trained in medical terminology, medical science, disease processes, anatomy, and physiology.Proficient in computer skills, including researching regulatory requirements online and navigating electronic medical records.Strong writing, organizational, and communication skills required.Experience:3-5 years of experience in a coding-related field. Knowledge of EMR systems, MS-DRG and APR-DRG reimbursement systems, ICD-10 CM/PCS, CPT, and HCPCS guidelines.Working Conditions:Requires long periods of sitting to review medical records. Ability to work under stressful conditions to maintain accounts receivable days, productivity, and accuracy.Work environment may be onsite or remote, adhering to the Flexible Work Arrangements Policy.Independent Action:Performs independently within departmental policies and practices. Refers complex issues to supervisors as needed.Supervisory Responsibility:None.Brown University Health is an Equal Opportunity employer and a VEVRAA Federal Contractor. All qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, age, ethnicity, sexual orientation, disability, veteran status, or marital status.#J-18808-Ljbffr