Permanent Clinical Coding Analyst (DRG/Clinical Validation) - Remote

Remote, USA Full-time
Enjoin is an industry leader committed to providing comprehensive clinical documentation improvement solutions that are physician-led and quality-driven. We are seeking an experienced and detail-oriented Clinical Coding Analyst to join our team. If you possess in-depth knowledge of DRG coding and clinical guidelines, we invite you to contribute your expertise to our dynamic organization. About the Role: We are seeking an experienced Clinical Coding Analyst to review pre-bill inpatient charts, ensure accurate MS-DRG assignment, identify revenue opportunities, write recommendations, and mitigate compliance risks. This role requires expertise in ICD-10-CM/PCS coding, DRG/clinical validation, and reimbursement methodologies, with a strong focus on quality and compliance. The ideal candidate will analyze medical records, provide detailed coding recommendations, and effectively communicate findings. Key Responsibilities: • Daily pre-bill chart reviews specific to DRG assignment. • Identify revenue opportunities and compliance risks based on the Official ICD-10-CM/PCS Guidelines for Coding and Reporting, AHA Coding Clinics, disease process, procedure recognition, and clinical knowledge. • Provides verbal review on all cases with a potential MS DRG recommendation and/or physician query opportunities with the Enjoin physician via phone call prior to writing up and submitting recommendations to the client. • Prepares and composes all recommendations, including increased reimbursement, decreased reimbursement, and “FYI” for each account and submits to the client within 24 hours of receiving and reviewing the electronic medical record. • Ensures that the daily work list is uploaded into the MS DRG Database for assigned client(s) and enter required data elements for each patient recommendation into MS DRG Database. • Follows internal protocol on all client questions and rebuttals on cases reviewed within 24 hours of receipt. • Responsible for review and appeal, if warranted, on Medicare and/or third-party denials on charts processed through the MS DRG Assurance program. • Responsible for reviewing inclusions and exclusions specific to 30 Day Readmissions and Mortality quality measures on specific cohorts for traditional Medicare payers for specific clients. Qualifications: • AHIMA coding credential of CCS, RHIT, RHIA, CDIP and/or ACDIS credential of CCDS required • Minimum of 7+ years of acute inpatient hospital coding, auditing, or CDI experience in a large tertiary trauma/teaching hospital required • Knowledge of ICD-10 CM/PCS required • Experience with electronic health records (i.e. Cerner, Meditech, Epic, etc.) required • Excellent oral and written communication skills required • Analytical ability, initiative, and resourcefulness required • Ability to work independently required • Excellent planning and organizational skills required Why Enjoin? • We are Great Place to Work Certified: This certification recognizes employers who create an outstanding employee experience • Be a valuable member of a dynamic team of physicians, CDI, and coding professionals • Career stability and professional growth opportunities • Monthly bonuses based on performance • Full benefits (medical, vision, dental) • 401(k) contribution of 3% • Excellent PTO package plus 8 paid holidays • Work 100% remote • Flexible schedule • Laptop and other necessary equipment provided • Complimentary annual CEUs • “White glove” onboarding/training • Access to advanced educational coding tools/resources • Employee Wellness and Discount programs • Referral bonus program for coding and CDI experts Work Environment: • This is a full-time remote position. General hours of work are Monday through Friday during regular business hours. • Must have a reliable internet connection, phone, and a dedicated, secure workspace to ensure adherence to HIPAA Privacy and Security policies and procedures when viewing Protected Health Information (PHI). • Enjoin provides a laptop and other necessary resources to perform duties. Interview Process: • Written DRG Validation/Clinical Validation Assessment • Video meeting with Manager (1 hour) • Multiple Choice Hogan Assessment (approximately 25 min) For more 35 years, Enjoin has provided health systems with clinical documentation integrity education, infrastructure and process development. A pioneer of CDI programs, Enjoin continues to be an industry leader and innovator. Led by nationally renowned physicians with a strong academic background in scientific-based medicine and years of clinical practice coupled with certified coding and clinical documentation credentials, our unique approach addresses today’s quality-driven initiatives uniting documentation and coding across the healthcare continuum. Enjoin is an equal opportunity employer and values diversity in its workforce. We encourage applications from all qualified candidates. Job Type: Full-time Pay: From $105,000.00 per year Benefits: • 401(k) • 401(k) matching • Dental insurance • Employee assistance program • Employee discount • Flexible schedule • Flexible spending account • Health insurance • Life insurance • Paid time off • Tuition reimbursement • Vision insurance Experience: • Inpatient (ICD-10CM/PCS) coding, auditing and/or CDI: 5 years (Required) • clinical validation: 2 years (Required) License/Certification: • CCS, RHIT, RHIA, CCDS and/or CDIP credential (Required) Work Location: Remote Apply tot his job
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