Inpatient Coder/Abstractor-Health Information Department
Shift: Full Time, days
Sentara Martha Jefferson Hospital, located in Charlottesville, VA, is a Magnet status, 176-bed facility featuring all patient-friendly private rooms. Since it's founding more than 100 years ago, Sentara Martha Jefferson has constantly evolved to meet the diverse healthcare needs of the patients who trust us with their care. Today, our vision is as clear as it was to our founders. We will continue to set the standard for clinical quality and personalized healthcare services. Sentara Martha Jefferson Hospital was recognized by Soliant Health as the 2012 Most Beautiful Hospital in America,
Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For more information about our employee benefits, CLICK HERE!
Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!
Codes inpatient accounts applying appropriate ICD-9-CM/ICD-10-CM/ICD-10-PCS/CPT-4 codes for hospital reimbursement, mortality & morbidity outcomes, research & statistical and regulatory compliance. Abstracts, codes and assigns necessary demographic and clinical data elements required for inpatient records. Effectively utilizes encoder software to assure appropriate reimbursement and accurate DRG & MSDRG assignment. Completes all work in accordance with defined productivity and quality standards. As necessary, consults or queries the physician for additional information or clarification of diagnoses, co-morbid/secondary conditions, and procedures. Provides physicians education on coding, documentation and medical necessity requirements. Assures optimal ethical reimbursement for coded encounters and assures coding practices fall within established compliance guidelines. Uses concurrent documentation database to accurately reflect queries and updates to DRG cases. Must work collaboratively with Nursing Staff on Concurrent Documentation Improvement Team for severity levels within coding guidelines. Performs other related duties as requested by HIM management.
High School Grad or Equivalent
Required: Coding - 2 years
Required: None, unless noted in the “Other” section below
Preferred: Cert Coding Specialist
Educational coursework in anatomy, physiology, and current coding practices required. CCS required within 1 year of hire
Keywords: Coder, Coding, Inpatient Coder, Abstractor, Health Information