Inpatient Coding and DRG Analyst

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🔥 9 minutes ago

🇺🇸 United States – 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 reviewing and coding complex inpatient medical records using ICD-10-CM diagnosis codes, ICD-10-PCS procedure codes, and appropriate MS-DRG/APR-DRG grouping methodologies. • Acts as lead resource on new regulatory updates, ICD-10 CM and Procedure code changes, and reimbursement methodologies. • Acts as the subject matter expert (SME) on DRGs. • Assists with analyzing coding data to identify trends, opportunities for improvement and potential risk areas. • Scrutinizes medical record documentation to identify trends, knowledge gaps, and documentation deficiencies. • Verifies accurate assignment of diagnoses and procedures within the medical record to comply with federal and state regulations. • Participates in creating a collaborative environment to promote excellence in coding and outcomes. • Supports provider education and collaborates with revenue cycle team to ensure optimal reimbursement and compliance with all regulatory guidelines. • Collaborates with Clinical Documentation Improvement (CDI), revenue integrity, billing, and compliance departments to ensure optimal DRG assignment. • Provides internal monitoring of coding and related data and provides detailed feedback to inpatient coding staff as well as leadership. • Assists in developing and maintaining coding policies, reference materials, and workflow improvements. • Supports preparation for external audits and ensure corrective actions are implemented. • Develops and delivers departmental specific training sessions, coding updates, and targeted education based on audit findings. • Research complex coding scenarios and payer rules; communicates updates to the team. • Assists in the management of the DNFB to ensure minimal number of uncoded days. • Maintains coding credentials and up-to-date knowledge of inpatient coding changes. • Provides guidance in daily workflow, prioritization, and problem resolution. • Adapts to changing department demands required to maintain high level of performance.

🎯 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 • Excellent organizational, interpersonal, verbal, and written communication skills • Knowledge and 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 ability to 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