This role is focused on Revenue Cycle Management (RCM) within a home infusion standard template environment. The position is part of a company dedicated to transforming care delivery through cloud-connected medical devices and software platforms.

The Medical Coding Specialist abstracts clinical information from health records and assigns accurate and complete codes following Official Guidelines for Coding and Reporting and iMedX standards. Key duties include identifying principal/secondary diagnoses, assigning ICD-10-CM/PCS codes, and understanding DRG-based reimbursement impact.

The role involves conducting thorough DRG payment validation reviews, including clinical and coding assessments of medical records to ensure accurate payment determinations based on contract-specific criteria. Key duties include meticulously documenting findings, providing clinical and policy support, and collaborating with stakeholders to maintain compliance with payment standards.

The specialist will coordinate and oversee the collection and administration of medical records from various facilities, while compiling, processing, and maintaining these records efficiently and in compliance with all regulations. They will also collaborate with clinical staff to expedite cases and develop relationships with medical record facilities.