• Review inpatient hospital records and assign accurate diagnosis and procedure codes • Determine the appropriate MS-DRG or APR-DRG assignment based on coding and clinical documentation • Conduct coding validation and auditing to ensure compliance with payer and regulatory requirements • Identify documentation gaps and communicate opportunities to providers, hospitals, and Clinical Documentation Improvement (CDI) teams • Analyze denials and underpayments related to coding and DRG assignment • Support retrospective and concurrent reviews of high-cost admissions and outlier cases • Collaborate with utilization management, case management, finance, and contracting teams to optimize reimbursement and cost containment • Assist with internal and external audits, including RAC, Medicare Advantage, Medicaid, and commercial payer reviews • Provide education and mentoring to coding staff and other stakeholders • Monitor changes in coding guidelines, reimbursement methodologies, and regulatory requirements • Prepare reports and summaries related to coding accuracy, financial impact, and audit findings • Maintain confidentiality and compliance with HIPAA and company policies • Other duties as assigned

• review medical records to identify pertinent diagnoses and procedures • select principal diagnosis and procedures using UHDDS definitions • ensure appropriate DRG assignment • abstract information from medical records based on client guidelines • meet productivity and quality performance requirements • utilize company applications to enter charts coded in real-time • solicit clarification from physicians regarding documentation • participate in team meetings and training • contribute to coding education within the team

• Process payments received and create batches for posting. • Identify underpayments and prepare appeals documents. • Code claims accordingly with CPT and ICD 10s codes. • Submit claims to clearinghouses and update or review claims corrections. • Communicate with patients, providers, and payers to check eligibility, pre-certify, or follow up on claims and appeals • Perform other duties as assigned by management

Role Description The inpatient senior coder will thoroughly review inpatient record accounts to assign correct ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes per industry coding guidelines, utilizing the 3M computer assisted coding software application. Abstracts coded data from the Epic electronic medical record according to the established standard of work, while maintaining established quality accuracy and productivity standards. Works collaboratively with leadership, financial and clinical teams to ensure Diagnostic Related Groups (DRG) or All Patient Refined Diagnostic Related Groups (APR-DRG) accuracy. The outpatient senior coder will review multiple service lines of outpatient services (ambulatory surgery, observation, interventional radiology/cardiology, emergency) record accounts to assign correct ICD-10-CM diagnosis codes, CPT procedure codes, add modifiers, review claim edits, etc. per the industry coding guidelines, utilizing the 3M computer assisted coding software application. Abstract coded data from the Epic electronic medical record according to the established standards of work, while maintaining the established quality accuracy and productivity standards. Essential Functions - Consistently Meets Monthly Productivity Standard: ≥100% - Consistently Meets Biannual Quality Standard: ≥95% - Use of an electronic medical record and encoder in a remote work environment. - Codes outpatient or inpatient records according to coding guidelines and conventions. - Assigns diagnoses and procedures for billing process, data retrieval and research purposes, using numerical codes of ICD-9-CM/ICD-10-CM/PCS and CPT-4 coding. - Provides education and training regarding coding guidelines of specialty area to clinical and non-clinical staff. - Communicates, collaborates and acts as a team player with others in order to ensure continuity of services. - Optimize codes for reporting and generates APCs for all outpatient records. - Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. - Participate in process improvement activities including but not limited to assuring accounts that cannot be coded are held for valid reasons. - Must attend all staff meetings required by management. Qualifications - High School Diploma or equivalent - 2 years of relevant experience coding - 1 of 5 certifications: - CRT-Coding Specialist (CCS) - AHIMA American Health Information Management Association Upon Hire - CRT-Registered Health Information Technician (RHIT) - AHIMA American Health Information Management Association - CRT-Registered Health Information Administrator (RHIA) - AHIMA American Health Information Management Association - CRT-Professional Coder – AAPC / American Academy of Professional Coders - CRT-Outpatient Coder, Certified (COC) - CPC – Certified Professional Coder Requirements - Associate’s degree in health information technology/management (Preferred) - Bachelor's degree Health information technology/management (Preferred) - ICD-10-CM, ICD-10-CPS, CPT coding experience (Preferred) Benefits - Comprehensive benefits package to meet your financial, health, and work/life balance goals. - On-demand pay program powered by Payactiv. - Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! - Optional identity theft protection, home and auto insurance. - Traditional and Roth retirement options with service contribution and match savings. - Eligibility for benefits is determined by employment type and status.