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Clinical Coding Analyst (Remote)
Clinical Coding Analyst (Remote)Toni Group • Scottsdale, AZ, US
Clinical Coding Analyst (Remote)

Clinical Coding Analyst (Remote)

Toni Group • Scottsdale, AZ, US
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Not hiring out of CA

Essential Job Duties and Responsibilities :

  • Clinical Coding Analysts are assigned to a specific client(s) and have the primary

responsibility of daily pre-bill chart reviews and communication via recommendations,

questions, and / or rebuttals to the client within a 24-hour time frame for each chart

reviewed.

  • Reviews the electronic health record to identify both revenue opportunities and
  • potential coding compliance issues-based ICD-10-CM / PCS coding rules, AHA Coding

    Clinics, and clinical knowledge.

  • Provide verbal review on all cases with a potential MS DRG recommendation and / or
  • physician query opportunities with the Physician(s) via telephone call prior to

    submitting recommendations to the client.

  • Ensures that the daily work list is uploaded into the MS DRG Database for assigned
  • client(s) and enter required data elements for each patient recommendation into MS

    DRG Database.

  • Prepares and composes all recommendations, including increased reimbursement,
  • decreased reimbursement, and “FYI” for each account and communicates that to the

    client within 24 hours of receiving and reviewing the electronic medical record.

  • Follows internal protocol on all client questions and rebuttals on cases reviewed within
  • 24 hours of receipt.

  • Responsible for review and appeal, if warranted, on Medicare and / or third-party denials
  • on charts processed through the MS DRG Assurance program.

  • Responsible for reviewing inclusions and exclusions specific to 30 Day Readmissions and
  • Mortality quality measures on specific cohorts for traditional Medicare payers for

    specific clients.

  • Maintains IT access at all client sites that have been assigned by ensuring that log on
  • and passwords have not expired.

  • Maintain current knowledge of ICD-10-CM / PCS code changes, AHA Coding Clinic, and
  • Medicare regulations.

  • Utilizes internal resources, such as TruCode, and CDocT.
  • Adhere to all company policies and procedures. Requirements :
  • AHIMA credential of CCS, CDIP or ACDIS credential of CCDS is required. 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.

  • Minimum of 7 years of acute inpatient hospital coding, auditing and / or CDI experience
  • in a large tertiary hospital required.

  • Experience with CDI (Clinical Documentation Improvement) programs preferred.
  • Extensive knowledge of ICD-10 CM / PCS required.
  • Experience with electronic health records (i.e., Cerner, Meditech, Epic, etc.) required.
  • Experience working remotely required.
  • Excellent oral and written communication skills required.
  • Must demonstrate analytical ability, initiative, and resourcefulness.
  • Ability to work independently required.
  • Excellent planning and organizational skills required.
  • Teamwork and flexibility required.
  • Must be proficient in Microsoft Office Word and Excel programs.
  • Schedule : Your schedule can be flexible based on your time zone and preferences. While our

    company generally operates between 8 : 00 AM and 5 : 00 PM EST / CST, you will schedule your

    two daily 20-minute Physician meetings anytime between 7 : 30 AM and 6 : 00 PM EST, allowing

    you to align your workday within this window for optimal collaboration. If you need to adjust

    your schedule for appointments or personal commitments, you can coordinate with your

    manager to ensure all charts are completed within the required timeframe. Video Call (1 hour)

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    Clinical Analyst • Scottsdale, AZ, US

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