If you are interested in joining the SunStone Consulting team, please send your resume and the position your are applying for to inquiries@sunstoneconsulting.com.
Senior Consultant Inpatient Coding
Job Description
Team player who is proficient with inpatient documentation, coding and billing in a workplace culture which emphasizes open communication and opportunities for growth. Must be organized and possess coding certification and/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. Experience in technical outpatient documentation, coding and billing preferred but not mandatory.
Responsibilities
Conduct inpatient and MS-DRG documentation, coding and billing reviews to identify opportunities for clinical documentation improvement, proper coding and reporting of diagnosis, procedures, CC’s and/or MCC’s in order 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.
Demonstrated proficiency in preparing accurate and thorough work papers, with clinically credible documentation references 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.
Qualifications
Bachelor of Science Degree in Health Information Management or/ Current licensure as a Registered Professional Nurse; BSN preferred.
Minimum of 10+ years of multi-entity health information and/or clinical/coding experience.
Strong clinical background with knowledge of anatomy, physiology and medical terminology commensurate with the ability to correctly code various types of services and diagnoses.
Ability to communicate and collaborate effectively with managers, clients and team members.
Demonstrates independent judgment, discretion, accuracy, analytical skills and decision-making abilities.
Proficient in Microsoft Office Suite including Word, Excel and e-mail application.