This is a fully remote position, open to applicants in United States.

📋 Description

• Perform timely, accurate, and comprehensive reviews of documentation for selected inpatient records, addressing any issues of inadequate or conflicting information.

• Work in collaboration with physicians and caregivers to ensure proper reimbursement and clinical severity for patients under DRG-based payers.

• Exhibit knowledge of complications, co-morbidities, illness severity, mortality risks, case mix index, secondary diagnoses, and the influence of procedures on DRG.

• Enhance coding specificity by instructing physicians and caregivers on the significance of clear documentation throughout a patient's hospitalization.

• Adhere to AHA guidelines and coding clinics to ensure accurate coding and necessary documentation for compliance.

• Inquire with physicians regarding any missing, unclear, or conflicting documentation in health records to obtain essential details.

• Keep daily production logs for assessment, tracking reviewed cases, and queries placed/responded to.

• Conduct follow-up reviews to verify recorded points of clarification within the patient’s medical record.

• Maintain confidentiality of all files, documents, and records.

• Achieve or surpass production and quality metrics.