Inpatient Coding and DRG Analyst

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

📋 Description

• Thoroughly reviewing and coding intricate inpatient medical records utilizing ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and applicable MS-DRG/APR-DRG grouping methodologies.

• Serving as the primary resource for updates on regulations, ICD-10 CM and Procedure code modifications, and reimbursement strategies.

• Acting as the subject matter expert (SME) on DRGs.

• Assisting in the analysis of coding data to uncover trends, areas for improvement, and potential risk factors.

• Examining medical record documentation to pinpoint trends, knowledge deficiencies, and documentation shortcomings.

• Confirming the accurate assignment of diagnoses and procedures within the medical record to adhere to federal and state regulations.

• Engaging in the creation of a collaborative atmosphere to foster excellence in coding and outcomes.

• Aiding provider education and working alongside the revenue cycle team to guarantee optimal reimbursement and adherence to all regulatory standards.

• Collaborating with Clinical Documentation Improvement (CDI), revenue integrity, billing, and compliance departments to secure optimal DRG assignment.

• Conducting internal monitoring of coding and associated data while providing comprehensive feedback to inpatient coding staff and leadership.

• Assisting in the development and upkeep of coding policies, reference materials, and workflow enhancements.

• Aiding preparation for external audits and ensuring the implementation of corrective measures.

• Developing and delivering departmental-specific training sessions, coding updates, and targeted education based on audit results.

• Researching complex coding scenarios and payer regulations; sharing updates with the team.

• Assisting in the management of the DNFB to ensure a minimal number of uncoded days.

• Maintaining coding credentials and staying informed about updates in inpatient coding.

• Providing guidance in daily workflow, prioritization, and problem-solving.

• Adapting to the evolving demands of the department to sustain a high level of performance.

⛳️ Requirements

• High School diploma or equivalent.

• Associate's degree preferred.

• Certified Coding Specialist (CCS) required.

• Four years of medical or hospital coding experience.

• Prior experience with an encoder and EMR computer systems.

• Exceptional organizational, interpersonal, verbal, and written communication skills.

• Knowledge and Skills: Trained in DRG assignment and the application of requirements necessary to comply with federal and local regulations.

• Capability to effectively manage multiple projects simultaneously and respond swiftly in a fast-paced environment.

🏝️ Benefits

• Medical Plan.

• Prescription drug coverage & In-House Employee Pharmacy.

• Dental Plan.

• Vision Plan.

• Flexible Spending Account (FSA) - Healthcare FSA - Dependent Care.

• Retirement Savings and Investment Plan.

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance.

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance.

• Disability Benefits – Long Term Disability (LTD).

• Disability Benefits – Short Term Disability (STD).

• Employee Assistance Program.

• Commuter Transit.

• Commuter Parking.

• Supplemental Life Insurance - Voluntary Life Spouse - Voluntary Life Employee - Voluntary Life Child.

• Voluntary Legal Services.

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance.

• Voluntary Identity Theft Insurance.

• Voluntary Pet Insurance.

• Paid Time-Off Program.