This role ensures accurate, compliant inpatient coding by developing and maintaining rules, policies, and procedures aligned with national billing and coding standards. It supports claims payment, reimbursement, system configuration, and health data analytics to improve cost efficiency and compliance. The position also reviews coding in provider contracts, recommends reimbursement standards, and participates in developing coding guidelines.
Requirements
Education: High school diploma required; Associate’s degree preferred.
Credentials: CCS required.
Experience: Minimum 5 years of inpatient coding experience.
Skills: Experience with encoder and EMR systems; strong organizational, communication, and interpersonal skills; denials management experience preferred.
Other: Ability to manage multiple projects and work efficiently in a fast-paced environment.
Essential Functions
Ensure accurate assignment of diagnoses and procedures in compliance with state and federal regulations.
Serve as the department’s DRG expert and stay current on regulatory changes.
Conduct advanced coding audits and support internal and external reviews.
Review coding-related denials, identify root causes, and recommend corrective training or process improvements.
Assist in implementing coding and quality-related policy updates.
Develop and deliver coding and documentation training for staff, providers, and related departments.
Provide management with statistical reports, audits, and compliance data.
Collaborate with Quality and other departments on HACs, PSIs, complications, and ICD-10 coding needs.
Adapt to changing departmental priorities and perform other duties as assigned.
Seniority Level
Associate
Employment Type
Contract
Job Function
General Business
Industries
Hospitals and Health Care
Staffing and Recruiting
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