Opportunity for a team player who is proficient with inpatient and outpatient documentation, coding and billing. Must be organized and possess RHIA certification or clinical expertise. The ideal candidate can work independently in a home office setting, is a problem-solver, taking on challenges independently with a strong attention to detail, who enjoys working in a collaborative and team-based environment.
- Conduct documentation, coding and billing reviews to identify opportunities for clinical documentation improvement, clarifying conditions/diagnosis and procedures to identify potential compliance risks and/or coding improvements.
- Apply knowledge of Official Coding Guidelines for ICD-10-CM and ICD-10-PCS, Coding Clinic and CPT Assistant to various coding situations.
- Assist with governmental or third-party payer denials by evaluating compliance with coding guidelines, LCD’s, NCD’s and any applicable CMS or managed care payer guidelines.
- Prepare accurate and thorough work papers, with clinically credible documentation clarifications to support findings.
- Develops education material and conduct education with clients on clinical documentation and coding opportunities, to include practitioners, clinical staff, allied health professionals and coders.
- Bachelor of Science Degree in Health Information Management or/ Current licensure as a Registered Professional Nurse; BSN preferred.
- Minimum of 7+ years of multi-entity health information and/or clinical/coding experience.
- Knowledge of anatomy, physiology and medical terminology commensurate with the ability to correctly code various types of services and diagnoses.
- Ability to communicate effectively with managers, clients and team members.
- Demonstrates independent judgment, discretion, analytical skills and decision-making abilities.
- Proficient in Microsoft Office Suite including Word, Excel and e-mail application.