Clinical Coding Analyst - CCA

MetaOption, LLC

13d•Remote

About The Position

Essential Job Duties and Responsibilities: Perform daily pre-bill chart reviews for assigned client(s); communicate recommendations, questions, or rebuttals within 24 hours. Review electronic health records to identify revenue opportunities and coding compliance issues using ICD-10-CM/PCS guidelines, AHA Coding Clinic, and clinical knowledge. Conduct verbal reviews with physicians via phone for cases with potential MS-DRG changes or query opportunities before submitting recommendations. Upload daily work list to MS-DRG Database and enter required data elements for each patient recommendation. Prepare and send all recommendations (increased/decreased reimbursement or FYI) to client within 24 hours of record review. Respond to client questions and rebuttals per internal protocol within 24 hours. Review and appeal Medicare/third-party denials for charts in the MS-DRG Assurance program, as warranted. Review inclusions/exclusions for 30-Day Readmissions and Mortality quality measures on specified Medicare cohorts for assigned clients. Maintain active IT access and credentials at all assigned client sites. Stay current on ICD-10-CM/PCS changes, AHA Coding Clinic, and Medicare regulations. Utilize internal resources such as TruCode and CDocT. Adhere to all company policies and procedures. Why is This a Great Opportunity This Clinical Coding Analyst role offers an outstanding opportunity for experienced professionals in healthcare coding and compliance. Here's why: Remote Work Flexibility High Demand and Job Security Meaningful Impact on Healthcare Revenue and Compliance Professional Growth and Intellectual Challenge Competitive Fit for Qualified Candidates

Requirements

AHIMA CCS, CDIP, or ACDIS CCDS credential (AHIMA ICD-10 CM/PCS Trainer preferred).
Minimum 7 years acute inpatient hospital coding, auditing, and/or CDI experience in large tertiary hospital.
Extensive ICD-10 CM/PCS knowledge.
Experience with electronic health records (e.g., Cerner, Meditech, Epic).
Remote work experience.
Proficiency in Microsoft Office Word and Excel.

Nice To Haves

Graduate of accredited Health Information Technology/Administration program with RHIT or RHIA credential.
CDI program experience.

Responsibilities

Perform daily pre-bill chart reviews for assigned client(s); communicate recommendations, questions, or rebuttals within 24 hours.
Review electronic health records to identify revenue opportunities and coding compliance issues using ICD-10-CM/PCS guidelines, AHA Coding Clinic, and clinical knowledge.
Conduct verbal reviews with physicians via phone for cases with potential MS-DRG changes or query opportunities before submitting recommendations.
Upload daily work list to MS-DRG Database and enter required data elements for each patient recommendation.
Prepare and send all recommendations (increased/decreased reimbursement or FYI) to client within 24 hours of record review.
Respond to client questions and rebuttals per internal protocol within 24 hours.
Review and appeal Medicare/third-party denials for charts in the MS-DRG Assurance program, as warranted.
Review inclusions/exclusions for 30-Day Readmissions and Mortality quality measures on specified Medicare cohorts for assigned clients.
Maintain active IT access and credentials at all assigned client sites.
Stay current on ICD-10-CM/PCS changes, AHA Coding Clinic, and Medicare regulations.
Utilize internal resources such as TruCode and CDocT.
Adhere to all company policies and procedures.