Inpatient/Outpatient Coding Specialist

3 weeks ago


New York, New York, United States Innova Solutions Full time

Job Summary

Innova Solutions is seeking a skilled Inpatient/Outpatient Coder to join our team. As a key member of our coding team, you will be responsible for conducting coding audits and education for providers with greatest opportunity for improvement.

Key Responsibilities

  • Conduct coding audits to ensure medical diagnosis and procedure codes submitted on provider claims are accurate.
  • Review medical records for physician documentation, clinical evidence that supports the diagnoses, medical necessity of procedures, appropriate setting of care, and accurate use of CMS coding guidelines.
  • Identify trends and inconsistencies in provider documentation and coding practices.
  • Develop curriculum to improve provider coding practices.
  • Educate providers and their practice staff in coding guidelines.
  • Collaborate with other departments to develop plans and materials that support education and system changes to ensure proper coding is a standard practice for all providers.
  • Participate in the review and analysis of summary data, assist with data collection, and report generation.

Requirements

  • Associate degree required.
  • 3-5 years of healthcare experience in a physician group practice or other ambulatory care setting preferred.
  • 1+ years of medical coding experience with demonstrated sustained coding quality.
  • In-depth knowledge of coding/classification systems appropriate for inpatient, outpatient, APR-DRG/MSDRG, and APC/APG prospective payment systems.
  • Demonstrated advanced knowledge of CPT/HCPS/Revenue Code procedure coding, ICD-9/ICD-10 coding principles, and practices.
  • Ability to research authoritative citations related to coding, compliance, and additional reporting requirements.
  • Demonstrated overall knowledge of claims processing for various insurances, both private and government.
  • Certification as a professional coder (CPC) is required.

Benefits

Innova Solutions offers a competitive salary and benefits package, including medical and pharmacy coverage, dental and vision insurance, 401(k), health savings account (HSA), flexible spending account (FSA), life insurance, pet insurance, short-term and long-term disability, accident and critical illness coverage, pre-paid legal and ID theft protection, sick time, and other types of paid leaves.

About Innova Solutions

Innova Solutions is a global leader in technology and business transformation solutions, employing approximately 50,000 professionals worldwide. We deliver strategic solutions to our clients, enabling them to operate as leaders within their fields.



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