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Senior Coding Specialist

2 months ago

Annapolis Junction, Maryland, United States Livanta Full time
Job Summary

Livanta is seeking a highly skilled Senior Coding Specialist to join our team. As a key member of our Medicare QIO operations, you will play a critical role in validating assignments of Medicare Severity Diagnosis Related Groups (MS-DRGs) used by Medicare Administrative Contractors (MACs) to calculate pricing for Medicare inpatient hospital claims.

Key Responsibilities
  • Coding and sequencing diagnoses and procedures using ICD-10-CM and ICD-10-PCS systems for MS-DRG assignment
  • Abstracting, interpreting, and validating hospital reporting of inpatient variables affecting Medicare payment models
  • Reviewing and interpreting clinical documentation to support coding and querying decisions
  • Performing inpatient coding audits and reviews
  • Recording clear and concise rationales for review decisions
  • Communicating with physicians and other stakeholders
  • Ensuring auditor and physician rationales are precise and complete
  • Elevating questions for supervisory guidance and resolution
  • Utilizing industry tools and information systems
Requirements
  • Appropriate AHIMA credential (RHIA, RHIT, or CCS)
  • Maintaining continuing education credits to ensure active credential status
  • Ability to pass background and employment screening
  • Experience performing higher-weighted DRG reviews for a Quality Improvement Organization or DRG reviews for a Medicare Recovery Audit Contractor
What We Offer

A competitive salary of $80,000 - $85,000 and a dynamic work environment.