Ann & Robert H. Lurie Children's Hospital of Chicago

Medical Billing and Coding

• Responsible for timely and accurate coding and abstracting of Inpatient visits
• Codes and abstract patients following established coding guidelines and utilizing ICD-10 code sets
• Ensures that revenue cycle, customer service, quality, individual, and team goals are met
• Thoroughly review of inpatient encounter documentation for diagnoses, treatments, services
• Performs daily coding and abstracting utilizing ICD-10 Code sets and DRG Grouping systems
• Validates MS-DRG and APR-DRG assignment for appropriateness to encounter
• Performs weekly coding of Inpatient Interim Bill Requests
• Review of Clinical Documentation Specialists notes and queries to ensure capture of queried conditions
• Validates admission diagnosis assignment and coordinates correction with Case Management personnel when appropriate
• Identifies documentation issues that may lead to incorrect coding, billing, and quality metrics
• Communicates issues to Clinical Documentation Specialists for clarification and/or resolution when appropriate
• Facilitates accurate Hospital Acquired Conditions reporting with Infection Control and/or coordinates retrospective query with CDI team as appropriate
• Performs research and/or seeks assistance from Nosology, CHA and American Hospital Association on complex coding cases
• Documents findings and educates team on coding guidance
• Makes recommendations on Epic coding and SVC edits to prevent coding, billing, IHA and claim edits
• Maintains quality standards of AHA, AMA, CMS, OIG and TJC pertaining to coding and reimbursement
• Stay current in Coding changes by reading, maintaining CEUs, and attending education sessions related to Coding and Health Information Management
• Trains and orients new employees
• Assists with testing and implementation of systems/product changes and upgrades
• Performs other duties as assigned by the coding manager or the director

HIM Coder III