Senior Facility Coder

Senior Facility Coder

Job Code: 29389

Position Summary

The Senior Facility Coder serves as the advanced technical resource for facility (hospital) inpatient and/or outpatient coding, ensuring coding accuracy and compliance for Kootenai Health. This role codes complex records, audits coded accounts, and provides real-time feedback and education to coding staff. This role partners with Billing, AR, Revenue Integrity, and Professional Services Coding to reduce denials and support timely, accurate billing and cash collections.

Responsibilities

• Reviews, interprets, and codes complex inpatient and/or outpatient medical records, assigning diagnosis, procedures, and grouping codes according to national, state, and local regulatory requirements and standard classification systems
• Meets or exceeds established coding productivity, quality, and turnaround standards, and assists with coverage of coding queues and work areas as needed
• Audits and monitors coded accounts, tracks errors and trends, and provides real-time feedback and education to coders to ensure accuracy and compliance
• Serves as a technical resource and subject matter expert for coding staff, resolving complex or escalated coding questions and assisting with the training and onboarding of new coders
• Analyzes coding-related denials and performance data, conducts root cause analysis, and recommends process improvements to resolve barriers and reduce rework
• Collaborates with Billing, AR, Revenue Integrity, Professional Services Coding, and clinical departments to support timely and accurate billing and cash collections
• Initiates and follows up on provider documentation queries to ensure the medical record supports the codes assigned
• Monitors and applies new coding laws, regulations, payer guidelines, and classification updates, and helps update coding policies, procedures, and workflows to ensure compliance
• Exercises discretion to establish new coding compliance policies or organizational standards
• Relies on experience and judgment to plan and accomplish goals
• Regular and predictable attendance is an essential job function
• Performs other related duties as assigned
• Competent to meet age-specific needs of the unit assigned

Requirements and Minimum Qualifications

• Associate’s degree in health information management or related field required; 2 years of related experience may be accepted in lieu of degree
• Bachelor’s degree preferred
• Minimum 5 years’ facility (hospital) inpatient and/or outpatient coding experience required
• Previous lead experience and/or coding audit experience preferred
• National certification from the American Health Information Association (AHIMA) as RHIA, RHIT, or CCS required
• Advanced knowledge of ICD-10-CM/PCS, CPT/HCPCS, and facility reimbursement methodologies, payer guidelines, and regulatory requirements
• Strong knowledge of anatomy, physiology, medical terminology, and disease processes
• Knowledge of 3M 360 and Epic software preferred
• Ability to audit records, analyze data, and identify trends and root causes
• Excel experience preferred
• Effective human relations and communication skills for interacting with all levels of hospital staff, the Revenue Cycle team, and providers
• Ability to educate and mentor coding staff and to deliver constructive feedback

Working Conditions

• Must be able to maintain a sitting position
• Typical equipment used in an office job
• Repetitive movements