Clinical Coding Analyst
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About The Position
The Clinical Coding Analyst is a credentialed coder, HIM professional or Registered Nurse with significant experience performing DRG audits and/or appeals. The Clinical Coding Analyst will perform inpatient chart reviews to identify coding opportunities that may impact DRG assignment or draft letters to appeal payor DRG denials. Each day may include a mix of these activities or may primarily focus on one or the other activities depending on case volumes. DRGs review include identification of revenue opportunities as well as coding and compliance risks. The appeals process includes reviewing the payor denial and authoring appeal letters when appropriate. The analyst should have expert knowledge of the Official ICD 10-CM/PCS Guidelines for Coding and Reporting and AHA Coding Clinics. In addition to strong coding knowledge, the Clinical Coding Analyst must be able to concisely articulate compelling, well-written, professional arguments to refute the payor’s assertion.
