Job Description
Are you an experienced coding professional with a passion for accuracy and compliance? As a Clinical Coding Analyst, you'll play a key role in pre-bill inpatient chart reviews, focusing on MS DRG (Medicare Severity Diagnosis-Related Group) assignments. This role combines your technical skills with your clinical expertise to identify revenue opportunities and ensure compliance with official coding guidelines.
This remote position offers the flexibility to align your work schedule with your preferences while maintaining a collaborative relationship with a supportive team.
What You'll Bring
We're looking for a detail-oriented, independent professional who meets the following qualifications:
Certifications: AHIMA credentials such as CCS or CDIP, or ACDIS credential CCDS (required). AHIMA Approved ICD-10 CM/PCS Trainer (preferred).
Education: Graduate of an accredited Health Information Technology or Administration program with RHIT or RHIA credentials (preferred).
Experience:
At least 7 years of acute inpatient hospital coding, auditing, or CDI experience in a large tertiary hospital (required).
Familiarity with CDI (Clinical Documentation Improvement) programs (preferred).
Proficient in ICD-10 CM/PCS.
Experience with electronic health records (Cerner, Meditech, Epic, etc.).
Prior remote work experience.
Skills:
Strong oral and written communication.
Analytical thinking, resourcefulness, and the ability to work independently.
Excellent planning and organizational skills.
Proficiency in Microsoft Word and Excel.
Your Key Responsibilities
As a Clinical Coding Analyst, you will:
Perform daily pre-bill chart reviews for assigned clients, ensuring all reviews are completed within 24 hours.
Identify potential revenue opportunities and compliance risks using ICD-10-CM/PCS coding rules, AHA Coding Clinics, and clinical knowledge.
Collaborate with physicians to discuss potential MS DRG recommendations or physician query opportunities before submitting to clients.
Maintain accurate data entry in the MS DRG database for client reporting.
Prepare and communicate recommendations (including reimbursement changes and "FYI" notes) to clients within established timeframes.
Review and appeal Medicare or third-party denials when necessary.
Support quality measures, including reviewing 30-day readmissions and mortality cohorts for traditional Medicare payers.
Ensure active IT access for assigned client sites and adhere to internal policies and HIPAA requirements.
Stay updated on ICD-10-CM/PCS code changes, coding clinics, and Medicare regulations.
Your Work Schedule
You have the flexibility to choose your work hours, but all analysts must submit daily client volumes by 7:00 AM EST. Team meetings with physicians can be scheduled between 7:30 AM and 6:00 PM EST.
Home Office Requirements
High-speed internet connection and a secure, dedicated workspace.
Compliance with HIPAA Privacy and Security policies for handling PHI (Protected Health Information).
A laptop and other necessary resources will be provided.
Interview Process
Case Study Skills Assessment - Focused on PCS Coding and Clinical Validation.
Video Call with Audit Manager/Team Lead - A one-hour session.
Verbal Case Study Discussion - A one-hour video call.
This opportunity is perfect for professionals passionate about accuracy in medical coding and looking for a flexible, remote role. We look forward to seeing how your expertise can contribute to the success of our clients.
Employment Type: Full-Time
Salary: $ 58,000.00 128,000.00 Per Year
Job Tags
Full time, Work experience placement, Self employment, Remote job, Home office, Flexible hours,