Process Analyst - Medical Coding (IPDRG)

Role Summary:

This job takes the lead in providing effective team handling and timely delivery of assigned tasks and requires strong knowledge in denial management, trend analysis, and expertise in reports management and process analytics with proven knowledge in hospital billing.

JOB SUMMARY

This role offers the opportunity to work in a challenging environment delivering high-quality solutions to meet global customer demands. The ideal candidate should have experience in hospital billing and denial management. The candidate should be able to lead and own the development of any technical deliverables assigned, delivering high-quality innovative solutions for the client. Should be an excellent team player with strong problem-solving and communication skills.

ESSENTIAL RESPONSIBILITIES

• Review medical records and code them to billable Revenue Code, CPT, Modifiers, Diagnosis code, and other relevant billable requirements
• Review documentation for compliance with quality standards and policies
• Prepare and provide information to west partners based on their expectations
• Identify and recommend improvements to documentation workflows and processes to improve accuracy and efficiency
• Specialized knowledge of Microsoft Excel to perform daily inputs, build functions, sort, and filter large amounts of data
• Adhere to all company and department policies regarding security and confidentiality

EDUCATION

• Graduation/BSc. in life sciences preferably clinical areas like Nursing, BDS, BAMS, BUMS, Clinical Biotech, Microbiology, etc.
• AAPC or AHIMA coding certifications required for all candidates

EXPERIENCE

Required:

• 3 - 6 years of experience in E/M Coding (E/M OP/Profee/Facility/IP) Surgery
• Exposure to multi-specialty and hospital provider coding
• Currently in an auditor role with exposure to quality-related reports

Preferred:

• Working knowledge of Epic and 3M 360
• Exposure to General and Cardiovascular Surgery coding
• Exposure to multiple specialties and/or claims edits
• Extremely detail oriented and able to multitask
• Strong in quality parameters
• High self-motivation and energy with minimal supervision
• Highly developed oral and written communication skills
• Ability to work independently and in a team environment
• Good organizational skills and strong attention to detail
• Identify process improvements, communicate through proper channels, and follow up until implementation
• Work in standard protocols/documents to complete assigned work accurately
• Consistently document work assignments, enrollment follow-up status, and relevant in-process tasks within specified systems and time frames
• Develop knowledge about payor policies
• Develop the team's talent and drive employee retention and engagement