Senior Medical Coding Analyst

Job Title: Senior Medical Coding Analyst

Position Summary:

Medical Coding Analyst is responsible for effective and efficient operations by enhancing various operational procedure in the areas of information flow and management, business processes, enhanced management reporting and looks for opportunities to expand and improve business outcomes. Should possess multi-specialty coding knowledge and be able to perform root cause analysis.

Essential Functions (Duties and Responsibilities):

75% Perform Medical coding related responsibilities and ensure seamless assignment codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes

• Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations
• Follow up with the provider on any documentation t hat is insufficient or unclear
• Communicate with other clinical staff regarding documentation
• Search for information in cases where the coding is complex or unusual
• Receive and review patient charts and documents for accuracy
• Ensure that all codes are current and active
• Responsible to maintain important logs and documentation regarding the details of the tasks performed
• Support an environment of accountability and management against goals
• Collaborate with cross-functional teams to resolve issues identified from day to day working of claims

15% Identify and quantify work trends

• Propose solutions to improve internal processes to facilitate a touchless revenue cycle
• Work with internal teams across the Operations Division to prioritize and implement process improvements appropriately prioritized based on impact and business need

10% Accept full ownership and responsibility for special projects

• Work with internal stakeholders and client-facing teams to identify and resolve claim issues impacting individual clients and/or discrete lines of business
• Communicate effectively the status and resolution of any special projects, adhere to established timelines, and serve as a valued subject matter expert for internal teams.

Education & Experience Required:

• Bachelors degree or equivalent
• 3-7 years’ experience in fast paced environment

Knowledge & Skills:

• CPC or CCS or equivalent
• Healthcare RCM knowledge, preferred
• Preferred Surgery coders only
• Analytical skills and good communication skills
• Ability to clearly articulate actions taken and articulate next steps
• MS office skills, required