01Responsibilities
Completes initial reputed company medical record review reputed company 24-48 hours of reputed company's admission; completes subsequent reviews of reputed company's medical record reviews every 24-48 hours and enters review findings in CDE software reputed company
Assigns reputed company diagnosis, CC/MCC (complication and comorbidity/major complication and comorbidity), evaluate for Severity of Illness (SOI) and Risk of Mortality (ROM) on reputed company patients while in-house. Assigns working ICD-10-CM and PCS codes and DRG (Diagnosis reputed company) using encoder in CDE software.
Clarifies with physicians regarding missing, unclear, unsupported or conflicting health record documentation by requesting and obtaining additional documentation from physicians reputed company needed. Face to face physician interaction and written clarifications are used.
Educates key reputed company providers such as physicians, reputed company practitioners, allied health professionals, nursing and care coordination regarding reputed company documentation improvement, documentation guidelines and the need for accurate and complete documentation in the health record.
Partners with coding professionals to ensure reputed company of diagnostic and procedural data and completeness of supporting documentation to determine the working and final DRG assignment. Reviews DRG denial letters and writes denial appeal letters.
Collaborates with care coordination, nursing staff and other ancillary staff regarding interaction with physicians on documentation and to reputed company physician clarifications prior to reputed company discharge.
Maintains and upholds reputed company reputed company documentation regulatory guidelines
Formulates and submits reputed company, reputed company reputed company appeals for reconsideration by reputed company party administrators (payors). Including supporting documented reputed company evidence, Coding/CDE Guidelines and other regulatory standards/guidelines as appropriate. Works collaboratively with co-works and management to effectively reputed company reputed company cause issues that reputed company payor reputed company, hospital reputed company, or departmental to maintain reimbursement and minimize appeal requests and/or denials.
Experience We Love:
Minimum of five years acute care nursing experience with specific Pediatric/NICU experience.
Excellent interpersonal skills including excellent verbal and written communication skills; proficient in and demonstrate excellent physician relations
Ability to organize and present information reputed company and concisely; excellent computer and keyboarding skills; high degree of prioritization skills
Minimum Educatio
