Medical Policy Analyst - US Tech Solutions : Job Details

Duration: 06+ months contract with potential extends or Convert

Job Description:

This position is responsible for reviewing clinical records to ensure appropriate billing practices utilizing industry standard coding resources.

Responsibilities:

Review requires the use of critical thinking and clinical judgment to make a clinical/coding determination for an individual case. The expectation and outcome from the review process is quality improvement and plan development recommendations. Review will be inclusive of but not limited to DRG and clinical validation reviews. Requires a current working knowledge of ICD-10 coding principles, government correct billing and coding regulation and protocols.

Experience:

• Requires a minimum of 3 years of acute care inpatient clinical experience.

• Requires 3 years' of hospital inpatient coding experience using ICD10 diagnosis and procedure coding within the last 2 years.

• Working knowledge of the DRG validation and regulatory requirements.

• Working knowledge of Evidence-based care guidelines/MCG a plus.

• Experience in claims processing and data management.

• Proficient in Excel.

• Experience with Adobe Pro

• Excellent written and verbal communication skills

Skills:

• Demonstrated proficiency in medical record review, chart audits and analysis.

• Demonstrated knowledge of diagnosis related group (DRG) assignments and DRG assignment tools. • Demonstrated knowledge of CPT/HCPCS, ICD-10-CM and PCS, coding conventions and rules. • Demonstrated experience with coding and claims processing systems.

• Demonstrated ability to apply critical review judgment to make relevant clinical determinations.

Education:

• Prefers a Bachelor Degree from an accredited college or university.

• Current/Active RN license required.

• Highly desirable CIC, COC, CPMA, CPCO

Education:

Requires an associate or bachelor's degree (or higher) in nursing and/or a health-related field OR accredited diploma nursing school.

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Recruiter Details:

Name: Rahul

Email: [email protected]

Internal Id: 25-29128