Inpatient Coding and DRG Analyst

Job not on LinkedIn

🕒 5 days ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $64.6k - $84.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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HCA Healthcare

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

🧬 Biotechnology

💰 Post-IPO Debt on 2014-06

Healthcare Insurance • Healthcare • Biotechnology

HCA Healthcare is a leading healthcare provider in the United States, dedicated to delivering high-quality medical services through a vast network of hospitals and outpatient facilities. They focus on enhancing patient care and improving health outcomes by utilizing advanced technologies and evidence-based practices. HCA Healthcare is committed to excellence and innovation in the health service sector.

📋 Description

• Accurately review and code complex inpatient medical records using ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and appropriate MS-DRG/APR-DRG grouping methodologies • Act as lead resource on new regulatory updates, ICD-10 CM and Procedure code changes, and reimbursement methodologies • Act as the subject matter expert (SME) on DRGs • Analyze coding data to identify trends, opportunities for improvement, and potential risk areas • Scrutinize medical record documentation to identify trends, knowledge gaps, and documentation deficiencies • Verify accurate assignment of diagnoses and procedures within the medical record to comply with federal and state regulations • Participate in creating a collaborative environment to promote excellence in coding and outcomes • Support provider education and collaborate with revenue cycle team to ensure optimal reimbursement and compliance with all regulatory guidelines • Collaborate with Clinical Documentation Improvement (CDI), revenue integrity, billing, and compliance departments to ensure optimal DRG assignment • Provide internal monitoring of coding and related data and detailed feedback to inpatient coding staff and leadership • Develop and maintain coding policies, reference materials, and workflow improvements • Support preparation for external audits and ensure corrective actions are implemented • Develop and deliver departmental specific training sessions, coding updates, and targeted education based on audit findings • Research complex coding scenarios and payer rules; communicate updates to the team • Assist in the management of the DNFB to ensure minimal number of uncoded days • Maintain coding credentials and up-to-date knowledge of inpatient coding changes • Provide guidance in daily workflow, prioritization, and problem resolution • Adapt to changing department demands required to maintain high level of performance • Perform other duties as assigned

🎯 Requirements

• High School diploma or equivalent • Associate's degree preferred • Certified Coding Specialist (CCS) required • Four years medical or hospital coding experience • Prior experience with an encoder and EMR computer systems • Possesses excellent organizational, interpersonal, verbal, and written communication skills • Instructed in DRG assignment and application of requirements needed to comply with federal and local regulations • Ability to effectively manage multiple projects simultaneously and respond quickly in a fast-paced environment

🏖️ Benefits

• Medical Plan • Prescription drug coverage & In-House Employee Pharmacy • Dental Plan • Vision Plan • Flexible Spending Account (FSA) - Healthcare • FSA - Dependent Care • Retirement Savings and Investment Plan • Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance • Supplemental Group Term Life & Accidental Death & Dismemberment Insurance • Disability Benefits – Long Term Disability (LTD) • Disability Benefits – Short Term Disability (STD) • Employee Assistance Program • Commuter Transit • Commuter Parking • Supplemental Life Insurance - Voluntary Life • Spouse - Voluntary Life • Employee - Voluntary Life • Child Voluntary • Legal Services • Voluntary Accident, Critical Illness and Hospital Indemnity Insurance • Voluntary Identity Theft Insurance • Voluntary Pet Insurance • Paid Time-Off Program