Inpatient Medical Billing and Coding Analyst and Cost Reviewer [PR0001B]
Core
Review inpatient health records and EMRs to validate provider, vendor, and internal diagnosis coding for accuracy, resolve claim denials, and prepare statistical reports.
Role type
Inpatient Medical Billing & Coding Analyst & Cost Reviewer
Builds
Accurate billing claims and HCC statistical reports for US Armed Forces Regional Health Command
Domain
Healthcare / Military Medical Services
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Inpatient coding, Risk adjustment coding, HCC coding, CPT codes, ICD-10-CM codes, MS-DRG classification, Medical terminology, Anatomy & physiology, Chart audits, Claim denial resolution, Charge corrections
Preferred skills
Clinical background, Chart abstraction experience, MS-DRG application, Pathophysiology knowledge
Technologies
Microsoft Office (Word, Excel, PowerPoint, Publisher, Adobe), EMR systems
Responsibilities
Review inpatient records for quality and comprehensive coding; Resolve daily coding scrubber errors; Resolve claim denials related to coding errors; Advise providers on billing and documentation policies; Develop preventive measures based on claims denial data analysis; Compile and report HCC statistical data
Seniority
Mid-level, hands-on IC