Tandym Group has an immediate opportunity for a Middle Revenue Cycle Consultant with a client in Texas who recently went live on Epic. The ideal candidate comes from a coding background, has done CDI and has also touched HIM. They will be focusing to get to the root problem of why is Case Mix Index running slower than usual, is it a documentation problem, an Epic problem, a 3M problem and work to increase case mix index.
This is a 25% travel, client-facing role that will be focused the following functions:
- Case Mix Analysis
- Analyzing case mix data (e.g., MS-DRGs, CMI) to understand patient populations and resource utilization.
- Identifying trends and patterns in patient characteristics and outcomes.
- Using case mix data to inform resource allocation and quality improvement initiatives.
- Core Coding
- Understanding and applying coding guidelines (ICD-10-CM, ICD-10-PCS, CPT) to ensure accurate code assignment.
- Collaborating with coding staff to resolve coding discrepancies and improve coding accuracy.
- Participating in chart audits and code reviews to monitor coding quality and compliance.
- HIM
- Documentation - Improving templates, etc.
- CDI
- Developing and implementing CDI processes to improve documentation quality.
- Educating providers and staff on clinical documentation best practices.
- Tracking CDI performance metrics and identifying areas for improvement.
Required Experience: - Experience within a large hospital or integrated healthcare delivery system.
- Minimum of 10 years of experience in Revenue Cycle Operations.
- Strong understanding of:
- ICD-10-CM, ICD-10-PCS, and CPT coding systems.
- Clinical Documentation guidelines and best practices
- Case mix analysis and MS-DRG Assignment
- 5 years of experience with CDI programs and processes.
- Experience working in an Epic Environment.
Preferred Experience: - HIM experience.
- Previous experience working for a consulting firm a huge plus but not required.
- Any Revenue Cycle certifications such as CRCR (Certified Revenue Cycle Representative)