Senior Clinical Coding Consultant, Registered Nurse

CSI Companies is actively seeking a Senior Clinical Coding Consultant, Registered Nurse to join our growing Medical Coding and CDI Practice.

The Senior Coding Consultant Registered Nurse, RN, provides subject matter expertise and project delivery oversight in the middle revenue cycle space.

In this role you will :

• Synthesize information obtained from various inputs including assessments, available datasets, chart reviews and financial reports to create value propositions for consulting engagements.
• Define client needs and designing a scope of work that addresses those needs, including assembling the appropriate resources on the project team
• Create a project delivery plan with timeline for execution in collaboration with the client and project team assigned resources
• Monitor the progress of the project, create status reports for the client and internal audiences and assure that there is contract compliance and profitability on assigned engagements
• Drive Risk Adjustment improvement initiatives
• Develop recommendations for Risk Adjustment remediation plans and create tools and databases to capture relevant data for assigned markets to achieve corporate and market specific Risk Adjustment goals and initiatives

Primary Responsibilities :

Perform client assessments using standardized and nouveau tools in the Middle Revenue Cycle (Coding, CDI and Risk Adjustment)

Conduct data analysis and benchmarking of client performance against industry best practices.

Review medical records for accuracy in MS-DRG, PDx, SDx and HCC capture. Synthesizes data into reports illustrating opportunities in improving compliance, quality and financial performance.

Create remediation plans and prescribes solutions for clients based upon assessment findings. Is able to present information to C-Suite executives and front line staff with command of subject matter and clarity.

Create delivery schedules, timelines and project work plans in collaboration with Managing Consultant.

Required Skills and Experience

Bachelor's Degree in Nursing (Associate's Degree or Nursing Diploma from accredited nursing school with 2+ years of additional experience may be substituted in lieu of a bachelor's degree)

Current RN license in good standing

RHIT, RHIA, or CCS certification

5+ years of associated nursing experience within a health care industry

2+ years of familiarization with ICD10 codes

Professional experience persuading changes in behavior

Knowledge of the Medicare market, products, and competitors

Knowledge base of clinical standards of care and preventative health measures

Ability and willingness to travel (locally and non-locally) as determined by business needs

Preferred Qualifications :

Undergraduate degree

Experience in managed care working with network and provider relations

Medical chart review experience

Medical / clinical background

Good business acumen, especially as it relates to Medicare

MS Office Suite, moderate to advanced EXCEL and PowerPoint skills

Solid presentation skills and relationship building skills with clinical / non-clinical personnel

Demonstrated ability to interact with medical staff, peers, and internal company staff at all levels

Ability to solve process problems crossing multiple functional areas and business units

Solid problem-solving skills; the ability to analyze problems, draw relevant conclusions and devise and implement an appropriate plan of action

About CSI

The CSI Companies is a recruiting firm established in 1994 that has been awarded "Best of Staffing" for 5 years in a row. We provide outstanding services to the world's leaders in the healthcare field as well as other organizations. For consideration, please submit your resume with all of your relevant experience included on it for immediate consideration. Only those candidates identified for an interview will be contacted.

Benefits Offered :

Weekly pay

Medical, dental, and vision coverage

Voluntary Life and AD&D coverage

Holiday pay and PTO

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