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. Heres why :
Remote Work FlexibilityHigh Demand and Job SecurityMeaningful Impact on Healthcare Revenue and ComplianceProfessional Growth and Intellectual ChallengeCompetitive Fit for Qualified CandidatesKey Skills
CSS,Cloud Computing,Health Education,Actuary,Building Electrician
Employment Type : Full Time
Experience : years
Vacancy : 1