Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS-DRG, APR-DRGs, and overall coding accuracy retrospectively and concurrently.
Provides continuing education to individual coders and the coding staff concerning changes in the coding and reimbursement system and any weaknesses identified during the coding validation reviews.
Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist, and effectively communicates with physicians and allied health personnel.
Assists with writing compelling appeals to all DRG denials from outside agencies, referencing Official Coding Guidelines and Coding Clinic advice as appropriate to defend the DRG assignment and protect the organization's reimbursement.
Serves as a resource to other departments in the Revenue Cycle to ensure business continuity and optimal revenue cycle management.
High School Grad or Equiv (Required), Technical/Vocational SchoolCertified Coding Specialist (CCS) - EV Accredited Issuing Body, Certified Professional Coder (CPC) - EV Accredited Issuing Body, Registered Health Information Administrator (RHIA) - EV Accredited Issuing Body, Registered Health Information Technician (RHIT) - EV Accredited Issuing Body
Pay Range: $26.29 - $48.91
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.