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Inpatient Coding Specialist III – Remote
Children’s Wisconsin

Location: Remote
Work Setting: Hospital
Job Function:
Job Type:


As a member of the healthcare team, the coding professional will support the importance of accurate,
complete and consistent coding practices for the production of quality healthcare data. The Coder III should
be proficient in coding the most complex types of coding cases (Inpatient) applying the correct ICD-9/ICD10-CM diagnosis codes, the newly developed and mandated ICD-10-PCS codes to inpatient procedure cases and strive for optimal reimbursement. The Coding Specialist III will have the ability to float to different coding areas as needed.

Job Description

 Exhibits guiding behaviors that reflect Children’s values and support our mission and vision.
 Assigns accurate ICD-9-CM/ICD-10-CM codes for all inpatient and outpatient diagnoses and ICD-10-
PCS codes for all inpatient procedures, while ensuring compliance with Official Coding Guidelines and
Ethical Coding standards along with state, federal and Joint Commission standards.
 Assigns accurate CPT codes for outpatient procedures as required by current coding policies and
procedures and /or regulations.
 Abstracts required data from all patient encounters in order to initiate and maintain a substantial data base for use by medical staff, students and other hospital personnel. Verifies all hospital activity and regularly communicates with various hospital departments to ensure the accuracy of patient information.
 Performs coding, abstracting and special studies according to established deadlines to facilitate the flow
of health information and the timely processing of patient billing. Enters diagnosis and procedure codes
and other required data into the data base for use in billing, indexes and studies.
 Monitors the effect of medical staff documentation on DRG reimbursement. Identifies and communicates documentation needs to physicians via a query process. Serves as a DRG/PPS (Diagnosis Related Group/Prospective Payment System) resource.
 Communicates with physicians and other clinicians concerning diagnoses and procedures when questions arise and/or when clarification is required, following hospital guidelines for the physician clarification process. Including appropriate and timely follow-up of queries as well as reviewing non-acknowledged Physician clarification for appropriateness and possible coding opportunity.
 Serves as a contact person with the Patient Accounts department to resolve billing and coding questions.
Works with the Patient Account Department to resolve interim bill requests and other issues.
 Supports the training of new employees by answering questions and performing peer review as needed.
 Participates in other projects as assigned by the team lead and/or Coding and Data Integrity Manager.
 Utilizes a Quality Assurance Plan to monitor the accuracy, consistency, sequencing and entry of
diagnostic, procedural, patient, and physician information.
 Participates in monthly coding team meetings and is knowledgeable in the hospital specific coding
guidelines pertaining to inpatient and outpatient.
 Attends educational seminars, reads pertinent health care literature and maintains credentials, in order to remain current in knowledge of standards and practice or health information management science.
 Interacts with patients, guests, physicians and staff in a courteous, professional manner. Demonstrates
appropriate work habits and demeanor which contribute to the effective functioning of the department.

Required Qualifications

 High School education or equivalent.
 Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) and/or CCS certification credentialing required.
 Requires knowledge of ICD-9-CM/ICD-10-CM, ICD-10-PCS and CPT classification systems as well as
the Official Guidelines for Coding and Reporting.
 Three years medical record coding experience and knowledge of DRG assignment and reimbursement
regulations as acquired in an acute care environment preferred.
 Requires excellent verbal and written skills to facilitate communications with medical staff, peers,
management and other hospital personnel.
 Requires experience coding through an encoder and should be proficient with Windows based
 Requires ability to adapt and participate in frequent changes of policies and procedures in response to
internal and external requirements for health care data.
 Requires ability to maintain accuracy, work independently and resolve problems effectively.


This is a benefits eligible position.

Instructions for Resume Submission

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Posted: December 28, 2022 at 12:37 PM
Post ID: 74059

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