Senior Inpatient Coder

University Hospital Newark, New Jersey
senior medical clinic compliance training health ob/gyn senior medical records reason manager identifying health information management
The primary purpose of the Senior Inpatient Coder position is to review hospital inpatient medical records and assign ICD-10 diagnosis codes and procedure codes that accurately reflect the reason for admission and patient severity. Follows established hospital inpatient coding guidelines and utilizes Coding Clinic and other resources to ensure compliance with national coding guidelines. Assists the Manager with training new coding staff and identifying opportunities for physician documentation improvement.


Bachelor's Degree in Health Information Management or a related field required. RHIA, RHIT and/or CCS required. Minimum of three (3) years of hospital inpatient coding experience in ICD-9 and ICD-10 diagnosis and procedure coding and DRG assignment required, preferably in a tertiary care, teaching environment with complex surgical, transplant, trauma, neurosurgery, Ob/Gyn, and neonatology services. Equivalent combination of knowledge, education, training, skills and/or abilities will be considered in lieu of the degree requirement. Knowledge of medical terminology, anatomy and physiology, disease processes, Coding Clinic, POA, query guidelines required. Knowledge of CMS, Medicaid and third-party payer coding, billing and compliance regulations required. Experience and/or use of an encoder (Clintegrity 360) and Epic electronic health record required. Must have the ability to balance multiple and changing priorities. Must be able to read, write and speak English and possess excellent verbal and written communication skills. Must be detail oriented, accurate, organized, and work well independently. Must have a working knowledge of computers and be able to navigate the internet. Must be proficient in Microsoft Office, especially with the use of Excel, Outlook, and shared files as daily tools. May be required to work evenings and/or weekends.

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