Nuvance Health Careers

Description

Summary:

Serves as the primary resource and mentor for the inpatient coding team, ensuring accurate assignment of ICD-10-CM, ICD-10-PCS and CPT codes, optimal DRG, Severity of Illness (SOI) and Risk of Mortality (ROM) values, and full compliance with official coding guidelines and regulatory requirements.

Responsibilities:

1. Acts as the main point of contact for inpatient coders, offering real-time coding support and resolving complex issues. 2. Reviews and validates coded records for quality assurance, maintaining a DRG and coding accuracy rate of at least 95%. 3. Interprets diverse clinical documentation�H&P, progress notes, orders, operative reports, and pathology results� to identify diagnoses, comorbidities, complications and procedures. 4. Assigns principal/secondary ICD-10-CM diagnoses, ICD-10-PCS procedures, present-on-admission indicators, HACs and CPT codes per UHDDS, Coding Clinic and official guidelines. 5. Initiates retrospective queries on inconsistent or incomplete documentation and collaborates with providers and the CDI team to obtain clarifications. 6. Partners with Clinical Documentation Improvement (CDI) specialists to elevate documentation accuracy and coding outcomes. 7. Mentors and trains new and junior coders: reviews 100% of their work during probation, delivers feedback, and tracks progress. 8. Assists the Coding Supervisor/Manager with workload distribution, resource planning and oversight of outside vendors. 9. Monitors coder work queues, unbilled accounts and exception lists; communicates backlog or missing documentation to management. 10. Collaborates with billing, registration and business office teams to address coding inquiries, payer denials and appeals. 11. Participates in regular coding audits, analyzes trends, identifies risk areas and recommends process improvements. 12. Stays current on coding updates, DRG restructures and regulatory changes via education sessions, coding clinics and journals. 13. Contributes to department-wide quality improvement initiatives and staff education on best practices. 14. Ensures adherence to all departmental policies, confidentiality standards and health & safety regulations. 15. Demonstrates professionalism, teamwork and respect for diversity in every interaction. 16. Performs additional duties as assigned to support the coding department�s goals.

Other Information:

This position requires a minimum formal education of High School Diploma and minimum of five years job-related experience.

Certification:  CPC, COC CCS-P

Required Skills:  Alpha & numeric data entry.  Specialized training in medical terminology and ICD-10-CM & CPT-4 coding.

Criteria Desired (Not Required):  Course work in Anatomy and Physiology.

Working Conditions:

Manual: significant manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment: Generally pleasant working conditions

Company: Nuvance Health

Org Unit: 2070

Department: Coders

Exempt: No

Salary Range: $33.21 - $61.68 Hourly