US-Coding Assoc III

R1 RCM • Chicago, IL

436d • $54,621 - $80,080

About The Position

The Inpatient Coding Quality Reviewer is responsible for reviewing inpatient coded cases to ensure coding completeness and accuracy. This role involves identifying potential coding and DRG errors, researching guidelines to support recommended changes, and communicating these changes to the involved coder. The Reviewer also provides expert coding advice and educational topics to the Regional Manager, IP Coding Quality, while conducting daily pre-bill reviews and maintaining productivity and quality standards.

Requirements

• Bachelor's or Associates Degree with CCS credential is required.
• A minimum of seven (7) years of hospital inpatient coding experience is required.
• Extensive knowledge of ICD-10-CM/PCS classification system and MS-DRG and APR-DRG methodologies is required.
• In-depth knowledge of medical terminology, human anatomy/physiology, pharmacology, and pathology is required.
• Expert knowledge of industry Official Coding and Reporting Guidelines along with CMS directives for ICD-10 coding is required.
• Proficient MS Office skills, specifically in Excel, and knowledge of various coding software/platforms and EMRs is required.
• Detail-oriented with the ability to work independently and maintain high productivity and accuracy rates is required.
• Effective communication skills to interact with other employees is required.
• Self-starter with the ability to manage tasks independently.

Nice To Haves

• Two (2) years of inpatient coding audit experience is preferred.
• Experience in a large (> 500 beds) hospital or multi-hospital health system is preferred.
• Training in hospital Clinical Documentation Improvement is preferred.
• Experience as a Coding Consultant with a consulting firm is preferred.

Responsibilities

• Audit records as defined in the coding quality review plan.
• Review cases flagged by the coding quality software daily for multiple hospitals, validating documentation completeness and identifying missed diagnoses and procedures.
• Propose physician queries and ensure accuracy of diagnoses, procedures, POA, discharge disposition, and DRG assignment.
• Perform retrospective coding quality reviews as requested.
• Maintain up-to-date knowledge of industry coding and documentation guidelines to ensure compliance with regulations.
• Communicate audit findings with coders in a timely manner and support teams in resolving coding issues.
• Maintain high productivity and accuracy rates in accordance with established auditing standards.
• Serve as an inpatient coding expert and resource for coding teams and other departments.
• Work with the Regional Manager to identify educational needs based on audit results.
• Assist with evaluation and testing of audit applications and updates as needed.
• Collaborate with the hospital's CDI team to address documentation issues.
• Assist with data compilation, generation, and analysis for reporting and performance improvement initiatives.
• Contribute to reducing coding compliance risks and enhancing company revenue goals.
• Maintain good working relationships with team members to advance hospital and company objectives.
• Assist with training of new auditors and other audits as requested.

Benefits

• Competitive pay range of $26.26 - $38.50 per hour based on role, level, location, skills, experience, and education.
• Opportunities for continuous learning and career exploration.
• Collaborative work environment that encourages contribution and innovation.
• Comprehensive benefits package including health insurance, retirement plans, and more.

What This Job Offers

• Job Type: Full-time
• Industry: Professional, Scientific, and Technical Services
• Education Level: Associate degree
• Number of Employees: 10,001+ employees