Clinical Coding Analyst (Remote)
IDj-53523
Job TypeDirect Hire
Remote TypeFull Remote
Not hiring out of CA
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.
• Provide 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 enter 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.
• Maintain current knowledge of ICD-10-CM/PCS code changes, AHA Coding Clinic, and
Medicare regulations.
• Utilizes internal resources, such as TruCode, and CDocT.
• Adhere to all company policies and procedures.
• 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.
• Provide 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 enter 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.
• Maintain current knowledge of ICD-10-CM/PCS code changes, AHA Coding Clinic, and
Medicare regulations.
• Utilizes internal resources, such as TruCode, and CDocT.
• Adhere to all company policies and procedures.
Requirements:
• 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.
• 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.
Schedule: 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)