Clinical Coding Analyst; Remote

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.
• Provides 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 enters 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.
• Maintains current knowledge of ICD-10-CM/PCS code changes, AHA Coding Clinic, and Medicare regulations.
• Utilizes internal resources, such as Tru Code, and CDocT.
• Adheres to all company policies and procedures.

• 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.

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)