Concurrent Medical Code Reviewer - CCS/Remote

University of Miami - Hialeah, FL

Full-time - Mid Level

Remote - Hialeah, FL

Educational Services

About the position

The Concurrent Quality Reviewer at the University of Miami is responsible for reviewing documentation in the electronic medical record (EMR) to ensure accurate assignment and sequencing of ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes. This role focuses on capturing encounter-specific diagnoses and procedures for accurate reporting and research, aiming for real-time coding accuracy and compliance with national guidelines. The position involves collaboration with various healthcare professionals to optimize documentation accuracy and provide educational training based on identified trends.

Responsibilities

• Review documentation in the EMR for accurate ICD-10 coding.
• Capture all encounter-specific diagnoses and procedures for reporting.
• Collaborate with providers, CDIs, Coders, and Quality teams to optimize documentation accuracy.
• Assign working DRGs and ensure accurate POA assignment and severity of illness coding.
• Identify trends for educational training for CDI teams and providers.
• Validate accuracy of codes assigned by computer-assisted coding software.
• Request clarification from providers on conflicting or incomplete documentation.
• Abstract relevant information into the coding application accurately.
• Communicate discrepancies and coding concerns to appropriate departments.
• Maintain coding quality and productivity standards of ≥ 95%.
• Attend department meetings and educational seminars to maintain certification.
• Prepare ad-hoc reports as requested by senior management.
• Mentor and educate providers and CDI teams on coding practices.

Requirements

• Bachelor's degree in a related field such as Business Administration, Health Care Administration, or Health Information Management.
• Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Inpatient Coder (CIC) certification.
• Minimum 5 years of coding experience in an inpatient hospital setting.
• ICD-10-CM/PCS medical coding experience.
• Strong knowledge of anatomy, physiology, medical terminology, and disease processes.
• Advanced technical skills in MS Office (Excel, Word, Outlook, PowerPoint).
• Experience with computer-assisted coding (CAC) software.

Nice-to-haves

• Familiarity with CCs, MCCs, Elixhauser, and other specialty-specific conditions.
• Ability to work independently in a remote environment with minimal supervision.

Benefits

• Competitive salaries
• Comprehensive benefits package including medical and dental insurance
• Tuition remission
• Continuing education opportunities