About the Job:
Clinical Coding Analyst (Remote)
The Clinical Coding Analyst role focuses on performing pre-bill inpatient chart reviews to ensure accurate MS DRG assignment. This critical position aids in maximizing revenue opportunities and minimizing compliance risks through detailed analysis based on Official ICD-10-CM/PCS Guidelines, AHA Coding Clinics, and comprehensive clinical knowledge. Based remotely, this role requires a high level of independence and analytical skill to optimize financial results and enhance coding integrity for healthcare services.
Compensation: DOE
Essential Duties and Responsibilities:
- Conduct daily pre-bill chart reviews and communicate findings to clients within a 24-hour timeframe.
- Provide daily client volumes to the Audit Manager by 7am EST for assignment purposes.
- Engage in verbal reviews with company Physicians for cases with potential MS DRG recommendation or physician query opportunities before submitting recommendations.
- Compile and submit well-structured recommendations including increased or decreased reimbursement and informational reports to clients within 24 hours of chart review completion.
- Handle client inquiries and rebuttals regarding reviewed cases promptly within a day of receipt.
- Review and respond to Medicare and third-party denials on charts processed, appealing when necessary.
- Analyze patient records for 30 Day Readmissions and Mortality for quality measures specific to traditional Medicare payers.
- Maintain IT access, ensuring login credentials are current and secure for all assigned client sites.
- Adhere to all internal company policies and procedures, ensuring a consistently high standard of work.
Minimum Position Qualifications:
- AHIMA credential of CCS, CDIP or ACDIS credential of CCDS required.
- Graduate of an accredited Health Information Technology or Administration program with RHIT or RHIA credential preferred.
- Minimum of 7 years of substantive acute inpatient hospital coding, auditing, or CDI experience in a large tertiary hospital.
- Extensive knowledge of ICD-10 CM/PCS.
- Proven experience with major electronic health records platforms such as Cerner, Meditech, and Epic.
- Experience in working remotely in a similar or related role.
Preferred Qualifications:
- AHIMA Approved ICD-10 CM/PCS Trainer preferred.
- Experience with Clinical Documentation Improvement (CDI) programs.
- Possess initiative and resourcefulness in tackling complex cases and issues.
- Ability to independently manage workload and prioritize tasks to meet strict deadlines.
- Team-oriented with a flexible approach to work and problem solving.
Skills:
- Excellent oral and written communication abilities.
- Strong analytical skills to draw accurate conclusions from complex data.
- Demonstrated proficiency in Microsoft Office applications, particularly Word and Excel.
- Resourceful in using internal and external informational resources such as TruCode, I10 Wiki, and CDocT.
- Strong planning and organizational skills to manage daily tasks and long-term projects effectively.
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