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Job Summary: Seeking a talented Remote Clinical Coding Analyst based in Scottsdale, AZ. As a Clinical Coding Analyst, you will be responsible for conducting pre-bill chart reviews for inpatient cases, focusing on MS DRG assignment. This role involves identifying potential revenue opportunities and ensuring compliance with applicable coding guidelines and regulations, including the Official ICD-10-CM/PCS Guidelines for Coding and Reporting, AHA Coding Clinics, disease processes, procedure recognition, and clinical knowledge.

Qualifications:
• Required credentials: AHIMA's CCS, CDIP, or ACDIS's CCDS. Preferred: AHIMA approved ICD-10 CM/PCS Trainer.
• Ideally graduated from an accredited Health Information Technology or Administration program with AHIMA's RHIT or RHIA credential.
• Minimum of 7 years of experience in acute inpatient hospital coding, auditing, and/or CDI in a large tertiary hospital.
• Experience with CDI programs is a plus.
• Extensive knowledge of ICD-10 CM/PCS is required.
• Proficiency in electronic health record systems (e.g., Cerner, Meditech, Epic, etc.) is required.
• Must have experience working remotely.
• Excellent communication skills, both written and oral.
• Strong analytical ability, initiative, and resourcefulness.
• Ability to work independently and demonstrate excellent planning and organizational skills.
• Must be a team player and flexible.
• Proficiency in Microsoft Office Word and Excel programs.

Responsibilities:
• Assigned to specific client(s) to conduct daily pre-bill chart reviews and communicate findings within 24 hours for each case.
• Provide daily client volumes to the Audit Manager before 7 am EST.
• Review electronic health records to identify revenue opportunities and potential coding compliance issues based on ICD-10-CM/PCS coding rules, AHA Coding Clinics, and clinical knowledge.
• Conduct verbal case reviews with the Company Physician(s) to discuss MS DRG recommendations and potential physician queries before submitting them to the client.
• Upload the daily work list into the MS DRG Database and enter required data elements for each patient recommendation.
• Prepare and compose recommendations for increased reimbursement, decreased reimbursement, and "FYI" for each account and communicate them to the client within 24 hours of reviewing the electronic medical record.
• Address client questions and rebuttals within 24 hours of receipt, following internal protocols.
• Review and appeal Medicare and/or third-party denials for charts processed through the MS DRG Assurance program, if necessary.
• Review specific cohorts for traditional Medicare payers to ensure compliance with 30 Day Readmissions and Mortality quality measures for assigned clients.
• Maintain IT access at all assigned client sites by monitoring logins and passwords.
• Stay updated on ICD-10-CM/PCS code changes, AHA Coding Clinic updates, and Medicare regulations.
• Utilize internal resources like TruCode, I10 Wiki, and CDocT.
• Adhere to all company policies and procedures.

Schedule: You will have the flexibility to choose your work hours. However, all CCAs must report daily client volumes to the Audit Manager by 7 am EST for appropriate assignment. Our company typically operates from 8 am to 5 pm EST/CST. You will schedule daily meetings with the Physician team within their availability from 7:30 am to 6 pm EST.

Home Office Requirements:
• High-speed internet connection and a dedicated secure workspace to ensure compliance with HIPAA Privacy and Security policies when accessing protected health information (PHI).
• The company will provide a laptop and access to necessary resources for your job duties.

Interview Process:
• Skills assessment through case studies on PCS Coding and Clinical Validation.
• One-hour video call with Audit Manager/Team Lead.
• One-hour video call for verbal case study discussion.