Job Description

Essential Job Duties and Responsibilities:

• Perform daily pre-bill chart reviews for assigned client(s); communicate recommendations, questions, or rebuttals within 24 hours.
• Review electronic health records to identify revenue opportunities and coding compliance issues using ICD-10-CM/PCS guidelines, AHA Coding Clinic, and clinical knowledge.
• Conduct verbal reviews with physicians via phone for cases with potential MS-DRG changes or query opportunities before submitting recommendations.
• Upload daily work list to MS-DRG Database and enter required data elements for each patient recommendation.
• Prepare and send all recommendations (increased/decreased reimbursement or FYI) to client within 24 hours of record review.
• Respond to client questions and rebuttals per internal protocol within 24 hours.
• Review and appeal Medicare/third-party denials for charts in the MS-DRG Assurance program, as warranted.
• Review inclusions/exclusions for 30-Day Readmissions and Mortality quality measures on specified Medicare cohorts for assigned clients.
• Maintain active IT access and credentials at all assigned client sites.
• Stay current on ICD-10-CM/PCS changes, AHA Coding Clinic, and Medicare regulations.
• Utilize internal resources such as TruCode and CDocT.
• Adhere to all company policies and procedures.

Qualifications

• Required: AHIMA CCS, CDIP, or ACDIS CCDS credential (AHIMA ICD-10 CM/PCS Trainer preferred).
• Preferred: Graduate of accredited Health Information Technology/Administration program with RHIT or RHIA credential.
• Required: Minimum 7 years acute inpatient hospital coding, auditing, and/or CDI experience in large tertiary hospital.
• Preferred: CDI program experience.
• Required: Extensive ICD-10 CM/PCS knowledge.
• Required: Experience with electronic health records (e.g., Cerner, Meditech, Epic).
• Required: Remote work experience.
• Required: Excellent oral and written communication skills.
• Required: Strong analytical ability, initiative, and resourcefulness.
• Required: Ability to work independently.
• Required: Excellent planning and organizational skills.
• Required: Teamwork and flexibility.
• Required: Proficiency in Microsoft Office Word and Excel.

This Clinical Coding Analyst role offers an outstanding opportunity for experienced professionals in healthcare coding and compliance. Here's why:

• Remote Work Flexibility
• High Demand and Job Security
• Meaningful Impact on Healthcare Revenue and Compliance
• Professional Growth and Intellectual Challenge
• Competitive Fit for Qualified Candidates

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