|Skills:||Strong working knowldege of inpatient hospital coding,microsoft office including excel
|Required Certifications:||AHIMA CCS or CCS-P or RHIA or AAPC or CPC or CIC or COC
|Required Experience:||3 to 4 years
|Preferred Experience:||5 to 7 years
Through review of client claims data, the analyst will
identify areas of missed coding or charges as they apply to hospital
reimbursement practices. Proprietary company software is used in conjunction
with client participation to present findings of claims and propose recommended
solutions for improved billing outcomes. Internally, the Medical Coding Analyst
works closely with team members to continually improve process and keep coding
and billing changes up to date within company knowledge bank. The Analyst also
provides support and education for the charge accuracy tool to the clients.
The Analyst may work closely with IT, Finance, Billing, Hospital Staff
and executives and must have the ability to prioritize multiple projects while
meeting goals and deadlines. The Charge Accuracy Analyst must stay up to
date with CMS and coding guidelines and regulations, as well as, communicate
these changes to help keep the charge accuracy tool working effectively.
Following hire the Analyst will successfully complete
training that includes application of coding and charging knowledge to company
specific analytics. Training is generally remote but may be done onsite when
This position requires some travel, frequency may vary.
- Review post edit claims data to analyze potential
- Understand payer contracts as defined within AppRev
tool to assess projected value of charge corrections.
- Audit & suggest correct coding for inpatient and
outpatient diagnosis and procedure codes, with and/or without access to
the medical record.
- Research payer standards and regulations including CMS
transmittals and LCD coverage exceptions.
- Understands & applies workflows and actionable
items for both administrative and end user’s in proprietary charge
- Acts as support to end user for general troubleshooting
of charge accuracy software.
- Present training materials via WebEx to new and
existing end users of Charge Accuracy tool.
- Host monthly meetings with clients to provide
consulting on charge errors and methods of correction and best practices.
- Participate in cross training sessions with team
- Identifies product or process issues and communicates
effectively to appropriate staff.
- Records work assignments and tracks deliverables.
- Maintains coding and billing knowledge through
education and certification requirements.
- Current coding certificate from AHIMA CCS, CCS-P or
RHIA, RHIT or AAPC certifications including CPC, CIC, COC. Credentials are
required to be maintained during employment.
Required Knowledge and Skills:
The ideal candidate will have the following experience and
- Strong working knowledge of Inpatient and/or Outpatient
hospital coding. 3-5 years preferred including OR procedures.
- Experience in hospital billing practices, audits,
denials or charging.
- Proficiency in Microsoft office suite products including
- Demonstrates professionalism required to work with
multiple levels of management.
- Excellent verbal and written communication skills.
- Independence when working in multiple software systems
with minimal IT support.
- Ability to navigate new software with minimal training.
- Hands-on attitude with the desire to support team
members and proactively share ideas and knowledge.
Additional Preferred Knowledge and Skills:
- Supporting software conversion processes
- Inpatient or outpatient coding auditor
- Creation and presentation of education materials for
coder, physician or other healthcare professionals.
- Data Analytics