Inpatient Coder

We're looking for a Coder to join the Cost Outlier Review team. These coders are working with NY Medicaid to review high cost claims (people that have been in the hospital for a long time) and may be up to multimillion dollar claims.

They are looking through the codes to ensure that everything is coded correctly before the nurses review to ensure care was delivered properly.

It is a team of 3 coders.

Must have a very strong understanding of Inpatient coding and NY Medicaid.

It is a 6 month contract with the ability to extend further as needed.

This individual will utilize his/her knowledge and expertise of the review program and coding guidelines to ensure that the assignment of coding/DRG is appropriate and consistent with ICD-10-CM Official Guidelines for Coding and Reporting and AHA Coding Clinic regulations.

• Review (re-abstract and recode) hospital medical records to validate that data received is substantiated by information in the medical record.
• Make appropriate referrals to Physician Consultants and RN Clinical Reviewers as necessary.
• Assist in analysis and reporting of results.
• Perform other medical record, utilization and quality assurance review activities as required.
• Validate physician consultant DRG review for adherence to coding guidelines.
• Assist with DRG training and implementation for staff.
• Other duties as assigned.

• Strong interpersonal skills with the ability to relate effectively to physicians, senior medical, nursing and administrative personnel.
• Excellent communication skills (both written and verbal).
• Technical knowledge of coding and DRG validation.
• Ability to work independently with minimal supervision.

• Licensed Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS) required.
• A minimum of one (1) year of hospital experience in the abstracting and coding of inpatient medical records required.
• ICD-10 certification, required.

30-38/hr

Remote (ideally located in NY with understanding of NY Medicaid)

Monday-Friday (40 hours) between 7am-5:30pm