Concurrent Medical Code Reviewer - CCS/Remote

Lensa; Hialeah (FL); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a Concurrent Medical Code Reviewer to ensure accurate coding in electronic medical records. This role emphasizes compliance with national coding guidelines while collaborating with healthcare professionals to capture essential diagnoses and procedures. Ideal candidates will possess a strong background in inpatient coding, analytical skills, and a commitment to maintaining high coding quality. Join a leading university-based health system that values diversity and offers competitive salaries and benefits, including medical and dental coverage. This is a fantastic opportunity to contribute to patient care and education in a dynamic environment.

Benefits

Medical insurance

Dental insurance

Tuition remission

Flexible working hours

Qualifications

• 5+ years inpatient hospital coding experience required.
• CCS, RHIT, RHIA, CIC certifications are highly desired.

Responsibilities

• Review and assign ICD-10 codes accurately and ethically.
• Collaborate with providers to clarify documentation discrepancies.

Skills

Attention to detail

Analytical skills

Communication skills

Organizational skills

Critical thinking

Proficiency with coding software

Education

Bachelor’s degree in Business Administration

Healthcare Administration

Health Information Management

Tools

MS Office

CAC systems

Job description

Concurrent Medical Code Reviewer - CCS/Remote

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The Concurrent Quality Reviewer reviews documentation in the electronic medical record (EMR) to ensure accurate assignment and sequencing of ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes, following national coding guidelines. The role focuses on capturing all encounter-specific diagnoses, procedures, and documented conditions for accurate reporting and research. The goal is to assign ICD-10 codes and DRGs in real-time by collaborating with providers, CDIs, coders, and multidisciplinary teams. This includes assigning a working DRG, capturing and ensuring POA, severity of illness, mortality risks, SDOH codes, and identifying trends for educational purposes.

1. Uphold compliance by assigning and sequencing accurate ICD-10 codes according to guidelines, demonstrating integrity and ethical coding practices.
2. Determine and assign principal diagnosis, significant secondary diagnoses, POA indicator, and procedure codes based on guidelines.
3. Validate code accuracy, recognize inappropriate applications, and revise codes based on expertise and documentation.
4. Proficiency in health information technology and coding applications is essential.
5. Analyze clinical documentation to ensure codes are supported and consistent.
6. Ensure MS-DRG, APR-DRG, SOI, and ROM are compatible and optimized, with priority given to CCs, MCCs, Elixhauser, and specialty-specific conditions.
7. Collaborate with providers for clarification on conflicting or incomplete documentation and reflect responses in code assignment.
8. Abstract relevant information into coding applications, including POA indicators.
9. Verify and revise discharge dispositions and admission status for accuracy.
10. Communicate discrepancies and concerns to relevant departments or leaders.
11. Stay current with regulatory changes and complete mandatory education.
12. Maintain coding quality and productivity standards (≥ 95%).
13. Participate in meetings and seminars, and maintain patient confidentiality per HIPAA and safety guidelines.
14. Mentor and educate providers and staff on coding practices.

Education: Bachelor’s degree in Business Administration, Healthcare Administration, or Health Information Management preferred.

Certification and Licensing: CCS, RHIT, RHIA, CIC highly desired.

Experience: Minimum 5 years inpatient hospital coding, ICD-10-CM/PCS experience, knowledge of anatomy, physiology, medical terminology, and disease processes. Experience with MS Office and CAC systems.

Skills and Aptitudes: Attention to detail, analytical skills, adherence to HIPAA, independent and collaborative work ability, proficiency with coding software, strong communication, organizational, and critical thinking skills, and capability to work remotely with minimal supervision.

The University offers competitive salaries and benefits, including medical, dental, and tuition remission. As South Florida's only university-based health system, UHealth provides leading-edge patient care, research, and education across over 100 specialties. We are committed to diversity and equal opportunity employment.

Job Details:

• Full-time
• Staff
• Pay Grade: H12

Additional Info: Seniority level: Mid-Senior; Industry: IT Services and Consulting; Job function: Administrative.