HCCS - Healthcare Coding & Consulting Services

Clinical Specialist

• Perform concurrent and retrospective reviews of inpatient medical records to improve the quality and accuracy of clinical documentation
• Identify opportunities to clarify documentation that supports accurate code assignment, severity of illness, risk of mortality, quality metrics, and reimbursement
• Collaborate with physicians through compliant query practices to obtain complete and accurate documentation
• Partner with inpatient coding professionals to ensure documentation supports appropriate code assignment and accurate DRG assignment
• Monitor assigned patient populations throughout hospitalization and perform follow-up documentation reviews as needed
• Apply current CMS regulations, ICD-10-CM/PCS coding guidelines, MS-DRG methodologies, and Coding Clinic guidance
• Promote provider education and documentation best practices that improve documentation integrity and patient outcomes
• Analyze documentation trends and identify opportunities for process improvement
• Participate in multidisciplinary collaboration to support documentation integrity initiatives
• Maintain productivity, quality, and compliance standards established by HCCS and our client partners.

Clinical Document Integrity Specialist

General

• Support orthopedic revenue cycle and denial management operations
• Understand the full revenue cycle, including coding, claim submission, payer follow-up, denial resolution, and appeals
• Initially focus on orthopedic denials and ERISA appeals
• Support billing, coding, accounts receivable, claims follow-up, and denial management needs across multiple specialties

Clinical Document Integrity Specialist

Denial Management Specialist – Orthopedic Services