Inpatient Clinical Data Quality and Coding Specialist
3 weeks ago
We are seeking a highly skilled Inpatient Clinical Data Quality and Coding Specialist to join our team. This role is pivotal in ensuring accurate clinical documentation and coding for inpatient services, with a focus on data quality, risk adjustment, and compliance. If you have an eye for detail and a passion for improving patient care through precise data, this is the role for you.
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Key Responsibilities:
Clinical Documentation and Coding Accuracy:
· Conduct comprehensive clinical documentation reviews – and place queries if necessary - to account for associated risks, particularly targeted comorbidities.
· Audit inpatient medical records to validate ICD-10-CM/PCS coding and DRG assignments.
· Analyze coding data for discrepancies, trends, and areas of improvement.
· Identify and address variables impacting mortality rates using provided tools and DRG models.
· Ensure diagnoses supporting model variables are documented as POA.
· Verify patient SOI documentation is appropriate and initiate queries when needed.
Subject Matter Expertise:
· Act as a resource on inpatient coding, DRG assignments, and SOI assessment.
· Collaborate with coding teams to resolve discrepancies and enhance overall coding accuracy.
Collaboration and Education:
· Partner with physicians and CDI specialists to bridge documentation gaps impacting coding quality.
· Provide targeted education and training for coding and clinical teams on documentation best practices and data quality improvement strategies.
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Qualifications and Skills:
Required Credentials and Experience:
· Certification: CCS and/ or CDIP/ CCDS.
· Experience: Minimum of 7 years in US healthcare, focusing on inpatient coding, data quality audits, and ICD-10-CM/PCS coding with expertise in DRG assignments.
· Knowledge Base: In-depth understanding of clinical documentation criteria for major conditions, severity of illness, and coding compliance.
· Familiarity with payer-specific policies, official coding guidelines, and regulatory standards (e.g., CMS, AHIMA, Joint Commission).
· Proficiency in EHR systems (e.g., Epic, Oracle-Cerner) and coding software tools (e.g., 3M, Nuance, Optum).
Desired Skills:
· Strong analytical skills to identify trends and discrepancies in coding data.
· Ability to collaborate effectively with multidisciplinary teams.
· Excellent communication and teaching skills for training and education initiatives.
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Hyderabad, India Doctus Data Services Private Limited Full timeAbout the Role:We are seeking a highly skilled Inpatient Clinical Data Quality and Coding Specialist to join our team. This role is pivotal in ensuring accurate clinical documentation and coding for inpatient services, with a focus on data quality, risk adjustment, and compliance. If you have an eye for detail and a passion for improving patient care through...
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Hyderabad, India Doctus Data Services Private Limited Full timeAbout the Role: We are seeking a highly skilled Inpatient Clinical Data Quality and Coding Specialist to join our team. This role is pivotal in ensuring accurate clinical documentation and coding for inpatient services, with a focus on data quality, risk adjustment, and compliance. If you have an eye for detail and a passion for improving patient care...
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Hyderabad, India Doctus Data Services Private Limited Full timeAbout the Role: We are seeking a highly skilled Inpatient Clinical Data Quality and Coding Specialist to join our team. This role is pivotal in ensuring accurate clinical documentation and coding for inpatient services, with a focus on data quality, risk adjustment, and compliance. If you have an eye for detail and a passion for improving patient care...
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Hyderabad, India Doctus Data Services Private Limited Full timeAbout the Role: We are seeking a highly skilled Inpatient Clinical Data Quality and Coding Specialist to join our team. This role is pivotal in ensuring accurate clinical documentation and coding for inpatient services, with a focus on data quality, risk adjustment, and compliance. If you have an eye for detail and a passion for improving patient care...
-
hyderabad, India Doctus Data Services Private Limited Full timeAbout the Role: We are seeking a highly skilled Inpatient Clinical Data Quality and Coding Specialist to join our team. This role is pivotal in ensuring accurate clinical documentation and coding for inpatient services, with a focus on data quality, risk adjustment, and compliance. If you have an eye for detail and a passion for improving patient care...
-
hyderabad, India Doctus Data Services Private Limited Full timeAbout the Role: We are seeking a highly skilled Inpatient Clinical Data Quality and Coding Specialist to join our team. This role is pivotal in ensuring accurate clinical documentation and coding for inpatient services, with a focus on data quality, risk adjustment, and compliance. If you have an eye for detail and a passion for improving patient care...
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