Senior Coding Specialist

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

📋 Description

• Conduct validation of Medicare Severity Diagnosis Related Groups (MS-DRG) reviews.

• Uphold necessary coding accuracy and productivity standards.

• Examine electronic and scanned medical records, comparing hospital-submitted codes with documentation.

• Maintain real-time case entries in the case review information system.

• Document clear and concise rationales for review decisions, including relevant references.

• Collaborate with physicians to gather medical insights that influence coding decisions.

• Ensure that coder and physician rationales are accurate and comprehensive.

• Engage with educators concerning potential hospital coding trends.

• Draft provider letters detailing review findings and suggesting amendments to submitted codes and MS-DRGs.

• Safeguard patient information in accordance with HIPAA and HITECH regulations.

• Participate in mandatory annual training.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Independently review, accurately allocate, and abstract diagnostic and procedural codes utilizing designated coding classifications.

• In-depth knowledge of ICD-10 codes and the DRG classification system.

• Proficient experience with Encoder, Grouper, and AHA Coding Clinic.

• Current unrestricted RHIA, RHIT, or CCS credentials are preferred.

• License must be recognized in the relevant jurisdiction(s) for the assigned work.

• RNs and other professionals with medical degrees are considered, provided they have a proven background in auditing clinical coding and supporting clinical documentation.

• Capability to apply all pertinent ICD-10 diagnosis and procedure coding guidelines for appropriate MS-DRG assignment.

• Senior-level inpatient hospital coding experience is required.

• Proficiency in writing in plain language and summarizing medical facts and coding principles with authoritative references.

• Ability to coordinate tasks and communicate effectively with physician reviewers.

• Capability to sit, read, work on a computer, and view a computer screen for extended durations.

• Must inform a Livanta HR Manager within five calendar days of any changes in status or disciplinary proceedings related to licenses or certifications.

• Compliance with HIPAA and HITECH confidentiality requirements is essential.

• Attendance at annual security awareness, rules of conduct, and conflict of interest training is mandatory.

🏝️ Benefits

• Fully remote work setup.

• Reasonable accommodations for individuals with disabilities.

• Equal employment opportunity commitment.

• Availability of extended work hours, weekends, holidays, and on-demand work.