Clinical Coding Analyst (Remote)

Remote Clinical Coder

Location : Dallas, TX

Job Summary :

The Clinical Coding Analyst role involves conducting pre-bill chart reviews for inpatient cases, focusing on MS DRG assignment.

The analyst is responsible for identifying both revenue opportunities and compliance risks, utilizing the Official ICD-10-CM / PCS Guidelines for Coding and Reporting, AHA Coding Clinics, knowledge of disease processes, procedures, and clinical knowledge.

About You :

• AHIMA credential of CCS, CDIP or ACDIS credential of CCDS required. AHIMA Approved ICD-10 CM / PCS Trainer preferred.
• Preferably a graduate of an accredited Health Information Technology or Administration program with AHIMA credential of RHIT or RHFA.
• Minimum of 7 years' experience in acute inpatient hospital coding, auditing, and / or CDI in a large tertiary hospital.
• Experience with CDI (Clinical Documentation Improvement) programs preferred.
• Extensive knowledge of ICD-10 CM / PCS required.
• Experience with electronic health records (., Cerner, Meditech, Epic, required.
• Experience working remotely.
• Excellent oral and written communication skills.
• Analytical ability, initiative, and resourcefulness.
• Ability to work independently.
• Excellent planning and organizational skills.
• Teamwork and flexibility.
• Proficient in Microsoft Office Word and Excel programs.

Essential Job Duties and Responsibilities :

• Review pre-bill charts daily for assigned clients within a 24-hour timeframe.
• Provide daily client volumes to Audit Manager by 7am EST.
• Identify revenue opportunities and coding compliance issues through review of electronic health records.
• Conduct verbal reviews with Company Physician(s) for potential MS DRG recommendations and physician queries.
• Upload daily work list and enter required data elements into MS DRG Database.
• Compose and communicate recommendations to clients within 24 hours.
• Address client questions and rebuttals within 24 hours.
• Review and appeal Medicare and / or third-party denials on charts processed through the MS DRG Assurance program.
• Review 30 Day Readmissions and Mortality quality measures for specific clients.
• Maintain IT access at assigned client sites.
• Stay updated on ICD-10-CM / PCS code changes, AHA Coding Clinic, and Medicare regulations.
• Utilize internal resources for coding and clinical validation.
• Adhere to all company policies and procedures.

Schedule :

You can choose your specific work hours, but you must report daily client volumes to the Audit Manager by 7am EST. The company typically operates between 8am-5pm EST / CST.

You will need to schedule daily meetings with the Physician team within their availability of 7 : 30am-6pm EST.

Home Office Requirements :

• High-speed internet connection and a dedicated secure workspace to ensure HIPAA compliance.
• The company will provide a laptop and access to necessary resources.

Interview Process :

• Case Study Skills Assessment (PCS Coding and Clinical Validation)
• Audit Manager / Team Lead Meeting Video Call (1 hour)
• Verbal Case Study Discussion Video Call (1 hour)
30+ days ago