The Senior Configuration Professional implements new features and changes to support operational and clinical systems, focusing on accessing and configuring integrated applications, which includes building modules, developing tables/reports, and creating complex functions. Responsibilities also involve advising the business, evaluating requests, troubleshooting, resolving testing issues, configuring processes, integrating, developing interfaces, and maintaining documentation.

This role is responsible for requesting and obtaining medical records from healthcare providers to ensure accurate documentation of member health conditions and optimize risk-adjusted revenue. Key duties involve provider outreach, coordinating efficient retrieval methods, and ensuring secure receipt and storage of records while strictly adhering to HIPAA.

The coder will accurately code inpatient medical records using ICD and CPT systems, ensuring compliance with MS-DRG classification standards and supporting high-quality documentation practices. Key tasks involve reviewing records, utilizing tools like Epic and 3M, and maintaining high coding quality through regular audits.

The primary focus is on coding high complexity medical records, such as surgical and specialty services, ensuring accurate charge capture and timely processing of work queues. Responsibilities also include resolving coding-related denials and consulting with providers regarding documentation for coding purposes.