Anly Clinical Development

About the role

As an Analyst, Clinical Content Development, you will be responsible for developing, enhancing, and incorporating ICD-10-CM/PCS coding edits content within Audit Expert (including HDM and the 360 platform), as well as DRG-related content. The role will also be responsible for developing and enhancing outpatient edits and incorporating CPT/HCPCS and PFS coding edits within our 360 platform. This role plays a critical part in ensuring compliance, accuracy, and value for our customers.

Responsibilities

• Developing coding edits that address coding regulations. That focuses on compliant coding practices, DRG validation and coding quality.
• Developing coding edits that address coding regulations, that focuses on regulatory guidelines for ICD-10-CM/PCS, CPT/HCPCS, and PFS.
• Gather and analyze Voice of Customer feedback and input from internal teams (e.g., Consulting Services, Support, Nosology) to identify opportunities for product improvement and added value.
• Evaluate customer suggestions and requests for product/edit enhancements and determine feasibility for implementation.
• Collaborate with consulting services, audit specialists, and other teams involved with auditing solutions.

Requirements

• Bachelors Degree or higher AND (4) four year’s experience inpatient code auditing (ICD-10-CM/PCS) in a private, public, government or military environment OR
• Associate’s Degree or higher (completed and verified prior to start) from an accredited institution AND (5) five years of related job experience in inpatient code auditing (ICD-10-CM/PCS) in a private, public, government or military environment AND
• RHIT or RHIA certification
• Years of experience with inpatient reimbursement and severity-adjusted models (i.e. MS-DRGs, APR-DRGs) and of inpatient denials management (i.e., DRG denials, RAC audits)
• Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).

Preferred qualifications

• Bachelor’s degree in Health Information Management or Nursing
• CCS certification
• Extensive experience with coding audits, RAC audits, DRG denials
• Experience working with state specific APR-DRGs
• Experience with DRG validation
• Experience with outpatient coding (CPT/HCPCS)
• Experience with inpatient clinical documentation improvement
• Experience working with international code sets
• Working knowledge and understanding of compliant coding
• Excellent attention to detail, time management and organizational skills
• Proficiency in Microsoft Office applications (Excel, Teams, Word, PowerPoint) with strong analytical skills
• Capacity for effective collaboration both within the organization and with external customers

Pay

$96,000 - $132,000, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate’s relevant knowledge, training, skills, work location, and/or experience.

Schedule & location

Remote - United States. Travel: May include up to 10% domestic/international travel.