Anly Clinical Development

SOLVENTUM•Remote - Ohio, OH

15d•$96,000 - $132,000•Remote

About The Position

At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you. As an Analyst, Clinical Content Development, you will be responsible for developing, enhancing, and incorporating ICD-10-CM/PCS coding edits content within Audit Expert (including HDM and the 360 platform), as well as DRG-related content. The role will also be responsible for developing and enhancing outpatient edits and incorporating CPT/HCPCS and PFS coding edits within our 360 platform. This role plays a critical part in ensuring compliance, accuracy, and value for our customers.

Requirements

Bachelors Degree or higher AND (4)four year’s experience inpatient code auditing (ICD-10-CM/PCS) in a private, public, government or military environment OR Associate’s Degree or higher (completed and verified prior to start) from an accredited institution AND (5) five years of related job experience in inpatient code auditing (ICD-10-CM/PCS) in a private, public, government or military environment
RHIT or RHIA certification
(3) years of experience with inpatient reimbursement and severity-adjusted models (i.e. MS-DRGs, APR-DRGs) and of inpatient denials management (i.e., DRG denials, RAC audits)
Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).

Nice To Haves

Bachelor’s degree in Health Information Management or Nursing
CCS certification
Extensive experience with coding audits, RAC audits, DRG denials
Experience working with state specific APR-DRGs
Experience with DRG validation
Experience with outpatient coding (CPT/HCPCS)
Experience with inpatient clinical documentation improvement
Experience working with international code sets
Working knowledge and understanding of compliant coding
Excellent attention to detail, time management and organizational skills
Proficiency in Microsoft Office applications (Excel, Teams, Word, PowerPoint) with strong analytical skills
Capacity for effective collaboration both within the organization and with external customers

Responsibilities

Developing coding edits that address coding regulations. That focuses on compliant coding practices, DRG validation and coding quality.
Developing coding edits that address coding regulations, that focuses on regulatory guidelines for ICD-10-CM/PCS, CPT/HCPCS, and PFS.
Gather and analyze Voice of Customer feedback and input from internal teams (e.g., Consulting Services, Support, Nosology) to identify opportunities for product improvement and added value.
Evaluate customer suggestions and requests for product/edit enhancements and determine feasibility for implementation.
Collaborate with consulting services, audit specialists, and other teams involved with auditing solutions.
Responsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.