Connect with Us share this page via facebook share this page via twitter sharethis page via linkedin

Inpatient Coder Advanced

Location: Rhinebeck, New York US


Requisition Number: 7961

Position Title:

External Description:

Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices.  Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations.





SUMMARY: Reviews, codes, and abstracts all inpatient medical records for statistical purposes and hospital reimbursement, using established coding guidelines. 


Responsibility I - Codes inpatient (IP) medical records accurately, completely, and timely, according to department standards

1.1 Reviews primary and secondary documentation throughout the medical record to delineate the following: 

- Principal diagnosis - Secondary diagnoses - Principal procedure - Secondary procedures then assign appropriate ICD-9-CM/CPT- 4 codes to same on all inpatient cases. 

1.2 Initiates a physician query when there is conflicting, incomplete, or ambiguous documentation in the record or additional information is needed for accurate coding. 

1.3 Engages 3M Encoder and Clinical Documentation Management Program (CDMP) worksheets to ensure accurate and complete coding and DRG assignment. 

1.4 Abstracts all require information accurately into the computer system(s) for reimbursement and statistical purposes. 

1.5 Collaborates with CDMP Specialists to assign correct DRG and codes, if necessary. 

1.6 Prints coding summary and places in front of the patient medical record. Maintains established performance and quality standards. 

Responsibility II - Remains abreast of all applicable Federal, State, regulatory, and hospital-specific coding guidelines. 

2.1 Applies applicable guidelines to all cases coded to ensure accuracy of selected codes 

2.2 Accesses and researches applicable reference materials to further support decision-making in code selection. 

2.3 Attends required educational sessions. 

2.4 Completes required continuing education credits (CEUs) to maintain certification. 

2.5 Updates coding books in a timely manner. 

2.6 Reads coding journals and other publications re: coding techniques. 

Responsibility III - Participates in Performance Improvement/Quality Assurance activities. 

3.1 Participates in reconciliations of CDMP DRG assignments. 

3.2 Assists in addressing DRG inquiries. 

3.3 Reports on software and hardware problems. 

3.4 Assists in training new coding staff. 

Responsibility IV - Assists in projects assigned by the Coding Manager. (e.g. reconcile outstanding cases)

4.1 Assists in the review of cases flagged by SMART (Coding Compliance software) tool. 

4.2 Assists in responding to codes rejected by the Patient Accounts computer system. 

4.3 Field inquiries about codes and DRG assignments, as needed. 

Responsibility V - Guest Relations: Demonstrates regard for the dignity and respect of all patients, family members, visitors, and medical center personnel as defined in the philosophy of Vassar Brothers Medical Center 

5.1 Displays a caring and courteous attitude and represents the medical center in a positive manner to all persons noted above. 

5.2 Promotes and contributes positively to intra-departmental and inter-departmental relationships with no more than two complaints in a six-month period. 

5.3 Maintains the confidentiality of employees and departmental information with no infractions. 

5.4 Adheres to departmental and medical center dress codes as observed by a supervisor, and wears a VBMC picture identification badge, 100% of the time. 

5.5 Demonstrates willingness to assist co-workers and/or to accept additional assignments as requested to support the department's efficiency as observed by the supervisor. 

5.6 Responds to all supervisor's requests for information and assists in a timely and courteous manner. 

5.7 Demonstrates a high level of mental and emotional tolerance and even temperament when dealing with people; uses tact, sensitivity, and sound judgment at all times. 


Education: High School diploma, courses in Anatomy and Physiology, Medical Terminology, Disease Pathology, ICD-9/10-CM, CPT-4 

Experience: Must have 8+ years of acute care coding experience. 

Working knowledge of encoders and must be computer literate

License: CCS required RHIA, RHIT or CCS or = coding credential. 

At least 3 years Inpatient hospital coding experience




Location: Rhinebeck-NDH 6511 Springbrook Avenue

Work Type: Full-Time

Standard Hours: 37.50

FTE: 0.940000

Work Schedule: DAY 7.5

Work Shift: Monday thru Friday

Org Unit: 877

Department: Health Information Management



Exempt: No







EOE, including disability/vets.


We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.

City: Rhinebeck

State: New York

Community / Marketing Title: Inpatient Coder Advanced

Company Profile:

Health Quest and Western Connecticut Health Network have combined to form a new nonprofit health system. The name for the new health system will be Nuvance Health. The new health system was created to provide communities across New York’s Hudson Valley and western Connecticut with more convenient, accessible and affordable care.

EEO Employer Verbiage:

Location_formattedLocationLong: Rhinebeck, New York US

Job Number: 31070