RN CLINICAL CODING ANALYST

General Function

The Clinical Coding Analyst acts as the primary point of contact for the review and coding of all claims or incidents reported to SVMIC by our policyholders.

The Clinical Coding Analyst assists with the identification of clinical risk issues used as part of SVMIC's data-driven decision-making model.

Major Duties and Responsibilities (Essential Functions)

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and / or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Analyze SVMIC claim files to identify appropriate coding selections.
• ICD coding in support of CMS, National Practitioner Databank, and other regulatory reporting obligations.
• Code clinical details relevant to the events pertaining to the claim, such as diagnosis, procedures, outcome, etc.
• Code other details relevant to the events pertaining to the claim, such as severity, location, and allegations.
• Research clinical and related claims information to compose a summary of events involved within the claim.
• Interact with peers for guidance and support to meet coding requirements.
• Participate in Analytics team meetings.
• Meet or exceed supervisor's expectations for productivity, quality, continuous improvement, and goal accomplishment.
• Contribute to SVMIC's success by identifying opportunities and making recommendations that may lead to improved processes.
• May participate in cross-functional teams.
• Ability to work remotely as business needs dictate.
• Regular and predictable on-site attendance required.
• Complete special projects and other duties assigned.

Requirements

• Associate Degree or above with a minimum of 36 months of specialized training required.
• Minimum of 3 years of clinical RN experience, medical-surgical or multi-specialty areas a plus.
• Minimum 2 years of other related health care experience.
• Valid RN license maintained and in good standing.
• Good understanding of clinical terminology, anatomy, and physiology, as well as medical conditions and clinical procedures.
• Proficient with Microsoft Office Suite and other software programs.
• Effective interpersonal skills and the ability to work independently and recognize when and how to effectively collaborate with others.
• Highly focused with good analytical and critical thinking skills, especially as it applies to claims data.
• Strong time-management skills.
• Professional designation in applicable insurance analytics is a plus.

Experience in coding is not required.

Professional Essentials

• Contribute to a positive, professional, creative, and innovative achievement-oriented work environment that emphasizes SVMIC's mission, vision, and values.
• As part of our inclusive environment, communicating ideas and needs makes space for disagreement over ideas and expeditious resolution.
• Appropriately prioritize multiple / complex tasks and responsibilities; effectively allocate time, optimize work practices, and handle interruptions effectively.
• Appropriately cope with the occasional stress that comes with interpersonal interactions in a standard office environment.
• Manage relationships with others in a professional, courteous manner.
• Receive and utilize constructive criticism to grow and develop professionally.
• Exercise integrity, discretion, and confidentiality when exposed to or interacting with sensitive and proprietary information.
• Stay current with constantly evolving business and technology by seeking out and participating in opportunities to grow technical and professional skills.

SVMIC's mission is to protect, support, and advocate for physicians and other healthcare providers. As a mutual company, our vision is to be the premier provider of medical professional liability insurance, education, and support in the markets we serve.

SVMIC is owned by its policyholders, and all its activities and strategic priorities focus on achieving its mission and vision.

For more information, visit www.svmic.com .

SVMIC is an equal opportunity employer, and we value diversity of all kinds.