About the Job:
Clinical Coding Analyst (Remote)
This exciting position offers the opportunity to engage with healthcare from a vital perspective, focusing on pre-bill inpatient chart reviews for MS DRG assignment. As a Clinical Coding Analyst, you play a crucial role in identifying both revenue opportunities and compliance risks in medical documentation. This role requires adept skills in navigating electronic health records, analyzing medical data according to coding standards, and efficient communication to maximize healthcare revenue integrity and compliance.
Compensation: DOE
Essential Duties and Responsibilities:
- Clinical Coding Analysts are assigned to review daily pre-bill charts for specific clients and are responsible for identifying and communicating critical findings within a 24-hour timeframe.
- Provides daily client volumes to the Audit Manager by 7am EST for effective assignment management and operational flow.
- Conducts thorough reviews of electronic health records to identify potential revenue opportunities and coding compliance issues, applying ICD-10-CM/PCS coding rules and AHA Coding Clinics.
- Engages directly with company Physicians via telephone for case discussions involving potential MS DRG recommendations or physician query opportunities prior to client submission.
- Responsible for accurately entering and updating patient recommendation data into the MS DRG Database for assigned clients and ensuring all recommendations are communicated to the client within 24 hours.
- Manages client queries and case rebuttals effectively, ensuring responses are communicated within 24 hours of receipt.
- Reviews and, if necessary, appeals Medicare or third-party denials for charts processed through the MS DRG Assurance program.
- Conducts specific cohort reviews involving 30 Day Readmissions and Mortality quality measures for standard Medicare payers.
- Maintains current IT access at all client sites by ensuring login credentials are active and up-to-date.
- Keeps abreast of updates in ICD-10-CM/PCS code changes, AHA Coding Clinics, and Medicare regulations.
- Utilizes internal resources such as TruCode, I10 Wiki, and CDocT for optimal job performance.
Minimum Position Qualifications:
- AHIMA credential of CCS, CDIP or ACDIS credential of CCDS is required.
- Minimum of 7 years of acute inpatient hospital coding, auditing and/or CDI experience in a large tertiary hospital.
- Extensive knowledge of ICD-10 CM/PCS.
- Proficiency in electronic health records systems such as Cerner, Meditech, Epic, etc.
- Experience working remotely.
- Strong oral and written communication skills.
- Proven ability to work independently with high-level planning and organizational skills.
Preferred Qualifications:
- AHIMA Approved ICD-10 CM/PCS Trainer preferred.
- Graduate of an accredited Health Information Technology or Administration program with AHIMA credential of RHIT or RHIA preferred.
- Experience with Clinical Documentation Improvement (CDI) programs preferred.
- Capable of teamwork and flexibility in a dynamic remote work environment.
- Excellent analytical skills, demonstrating initiative and resourcefulness.
Skills:
- Proficiency in Microsoft Office Word and Excel.
- Ability to adhere to HIPAA Privacy and Security policies and procedures while managing protected health information (PHI).
- Effective time management and adherence to schedules as daily client reports are time-sensitive.
- Strong problem-solving skills to handle client questions and case revisions quickly.
- Excellent interpersonal and coordination skills for daily interactions with Physician team and clients.
- Long-term commitment to maintaining up-to-date knowledge on codes, Medicare regulations, and company policies.
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