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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 : Requirements :
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.
Why is This a Great Opportunity :
This Clinical Coding Analyst role offers an outstanding opportunity for experienced professionals in healthcare coding and compliance. Here's why :
Remote Work Flexibility
High Demand and Job Security
Meaningful Impact on Healthcare Revenue and Compliance