Anly Clinical Development

SOLVENTUM•Remote - Ohio, OH

10d•$96,000 - $132,000•Remote

About The Position

Solventum is a new healthcare company with a long legacy of creating breakthrough solutions for 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. 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. Developing coding edits that address coding regulations, focusing on compliant coding practices, DRG validation, and coding quality. Developing coding edits that address coding regulations, focusing 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. Corporate policies, procedures, and security standards must be complied with while performing assigned duties.

Requirements

Bachelor’s Degree or higher (completed and verified prior to start) from an accredited institution AND (7) seven years of related job experience in inpatient code auditing (ICD-10-CM/PCS) in a private, public, government or military environment OR High School Diploma/GED AND (11) eleven years' experience in inpatient code auditing (ICD-10-CM/PCS) in a private, public, government or military environment
RHIT or RHIA certification
CCS certification
(3) years of experience with inpatient reimbursement and severity-adjusted models (i.e. MS-DRGs, APR-DRGs)
Experience with 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).
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

Nice To Haves

Bachelor’s degree in Health Information Management or Nursing
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

Responsibilities

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.
Developing and enhancing outpatient edits and incorporating CPT/HCPCS and PFS coding edits within our 360 platform.
Developing coding edits that address coding regulations, focusing on compliant coding practices, DRG validation, and coding quality.
Developing coding edits that address coding regulations, focusing on regulatory guidelines for ICD-10-CM/PCS, CPT/HCPCS, and PFS.
Gathering and analyzing Voice of Customer feedback and input from internal teams to identify opportunities for product improvement and added value.
Evaluating customer suggestions and requests for product/edit enhancements and determining feasibility for implementation.
Collaborating with consulting services, audit specialists, and other teams involved with auditing solutions.
Complying with corporate policies, procedures, and security standards while performing assigned duties.