Tandem Hospital Partners

  • DRG Health Information Coder (HIM)

    Job Locations US-TX-Houston
    Job ID
    2018-1406
    # of Openings
    1
    Category
    Accounting/Finance
    Name
    Corporate Office
  • Overview

    Tandem Logo

     

    Tandem Hospital Partners works with leading hospital systems across the U.S. to build and operate state-licensed, CMS-accredited, acute care neighborhood hospitals.  These next-generation hospitals offer convenient, 24/7 neighborhood access to high quality, compassionate emergency and inpatient care, offering low wait times and an exceptional patient experience.

     

    Tandem’s strong clinical, retail, and hospital experience establishes us as the preferred partner in this emerging, innovative industry segment with the most experienced, collaborative, values-driven leadership team.  By partnering with Tandem, hospitals can meet the growing demand for emergency and inpatient services in communities where they are currently underrepresented, providing more convenient access to high quality, integrated and patient-centered care.

     

    Job Opportunity –  DRG Health Information Management Coder

     

    Our DRG Health Information Coder is responsible for assignment of accurate ICD-10-CM/PCS and DRG validation of inpatient hospital records. Also responsible for the accurate assignment of Evaluation & Management (E&M) Codes, ICD-10 diagnosis, CPT, HCPCS and modifiers for ambulatory records.

    The HIM Coder will work closely with coders, clinical departments, administrators and physicians to ensure the accurate capture of all charges.

      

    The successful candidate should also have a strong focus on quality and collaboration, with a servant heart and the ability to create value across the company.

     

    We are looking for an innovative thinker. An enthusiastic professional to become part of the energy and join our team where you will engage in our efforts to improve patient satisfaction, clinical outcomes and operational efficiency. 

    Responsibilities

    Essential Functions

    • Upholds the values and mission of the Tandem Hospital Partners family
    • Responsible for review and input of coded information utilizing various programs within the computer system efficiently and timely
    • Assigns correct ICD-10, CPT, HCPCS, DRG and modifiers on all charges billable to the patient and/or insurance carrier via chart abstraction
    • Sequences the diagnoses and procedures using coding guidelines
    • Reviews discharge lists daily to ensure all accounts have been processed for coding. Finalizes accounts within four business days from patient discharge
    • Reviews the record for compliance with established third-party reimbursement agencies
    • Acts as liaison between the Billing Department and medical staff, clinical staff for coding and documentation issues
    • Queries physicians or clinician when code assignments do not match the documentation presented in the patient record, or when documentation is inadequate, ambiguous, unclear or illegible for coding purposes
    • Abstracts and compiles data from the patient medical record for appropriate reimbursement for professional and/or facility charges
    • Meets all month end closing processes to ensure coding is completed on a timely basis
    • Reports any backlog to the HIM Manager daily.
    • Abides by the Standards of Ethical Coding as set for by AAPC and AHIMA
    • Contribute to team environment by performing other duties as assigned

    Qualifications

    Minimum Qualifications

    • High School Diploma or GED 
    • At least three (3) years of current coding experience; with CPT/ICD-10 & HCPCS coding for professional and facility charges preferred
    • Certified Coder Certification - RHIT, RHIA or CCS

     

    Knowledge, Skills and Abilities

    • Demonstrated knowledge of ICD-10-CM/PCS, CPT, and HCPCS coding guidelines and principles required
    • Ability to understand basic billing and coding concepts
    • Ability to define problems, collect data, establishes facts, and draw valid conclusions
    • Able to demonstrate full knowledge of insurance payers and their coding requirements per their Clinical Policy Bulletins, NCCI edits and Medicare LCDs
    • Strong ICD-10, HCPCS and CPT Coding knowledge
    • Ability to learn new computer applications quickly and independently and become a skilled user of the company’s or JV partner’s proprietary database. Demonstrated familiarity with a variety of practice management software, including EHRs/ EMRs
    • Knowledge of 3M Coding and Reimbursement System, Encoder-Plus and/or Optum 360 Encoder Pro
    • Knowledge of anatomy and physiology, medical terminology and disease processes through participation in continuing education programs to effectively assign ICD-10, HCPCS and CPT coding guidelines to maintain accuracy and optimize reimbursement
    • Maintains a thorough understanding of medical record practices, standards, regulations, HIPAA, CMS, EMTALA, JCAHO and other applicable state regulatory and compliance standards
    • Adheres and follows all hospital and departmental policies and procedures
    • Maintains patient confidentiality at all times according to the hospital established policies and procedures
    • Demonstrated ability to work independently while managing work load and to work efficiently while meeting established guidelines
    • Must have strong attention to detail, effective problem solving, analytical skills and communication skills

     

    Location

    Home Office, Downtown, Houston, TX

     

    Travel Required

    Up to 25% depending business needs

     

    Eligibility Requirements

    If you are applying for a position in the United States, you must be at least 18 years of age, legally authorized to work in the United States, and not require sponsorship for employment visa status (e.g. TN, H1B status), now or in the future. The Company strongly values diversity and is committed to equal opportunity and non-discrimination in all policies and practices, including the area of employment. We are proud to be an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, Veteran status, gender identity or expression, genetic information or any other legally protected status. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

     

    The essential functions listed are typical examples of work performed by positions in this job description and are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks and responsibilities. Specific duties and responsibilities may vary depending on department or program needs without changing the general nature and scope of the job or level of responsibility. Employees may also perform other duties as assigned.

     

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