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.