Clinical Coding Analyst

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

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