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Catalyst Clinical Coding Analytics Jobs in Washington

Unity Health Care

Medical Coding Specialist

Washington, DC · On-site

$25 - $30.76/hr

... clinical information. * Assign accurate ICD-10-CM, CPT, HCPCS Level II, and modifier codes based on provider documentation. * Register, analyze, and process claims within the electronic medical ...

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Catalyst Clinical Coding Analytics information

What is the difference between Catalyst Clinical Coding Analytics vs Clinical Coding Specialist?

AspectCatalyst Clinical Coding AnalyticsClinical Coding Specialist
CertificationsTypically requires coding certifications (e.g., CPC, CCS)Requires coding certifications (e.g., CPC, CCS)
Work EnvironmentData analysis, reporting, and coding review in healthcare settingsAssigns codes to patient records in healthcare facilities
Industry UsageUsed in healthcare analytics, revenue cycle managementUsed in hospitals, clinics, and healthcare providers

Both roles require coding certifications and work within healthcare environments, but Catalyst Clinical Coding Analytics focuses on data analysis and reporting, while Clinical Coding Specialists primarily assign codes to patient records. Understanding these differences helps clarify career paths and employer expectations in healthcare coding and analytics.

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Catalyst Clinical Coding Analytics jobs near you

Manager of DRG Coding & Clinical Validation Audit

Elevance Health

Annapolis Junction, MD • On-site

$115K - $207K/yr

Other

Medical, Retirement

Posted 5 days ago

Elevance Health rating

7.7

Company rating: 7.7 out of 10

Based on 349 frontline employees who took The Breakroom Quiz

200th of 303 rated insurance

Job description

Manager of DRG Coding & Clinical Validation Audit

Manager of DRG Coding Audit-Program/Project

Locations: The selected candidate must reside within a reasonable commuting distance of the designated posting location(s): Virginia, Indiana, Georgia, Ohio, Maryland; New Jersey, New York and Texas.

Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

The Managers of DRG Coding & Clinical Validation leads a high-performing team responsible for auditing inpatient medical records to ensure the accuracy and compliance of Diagnosis-Related Group (DRG) assignments. This role plays a critical part in identifying coding discrepancies and recoverable claim opportunities, and supporting regulatory integrity on behalf of the company and its clients.

How you will make an impact:

  • Sets the strategic direction for audit methodologies, oversees team development, and ensures that audits meet the industry's best practices and payer-specific requirements.
  • Collaborates cross-functionally with clinical, compliance, provider engagement, and data analytics teams to align audit insights with broader program goals.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.
  • Analysis of audit trends, DRG shifts, and using financial outcomes to inform strategy.
  • Plans program/project scope and design.
  • Develops metrics and program/project reporting tools.
  • Analyzes variance to program/project plan.
  • Leads building of documentation to support business objectives and ensure consistency.
  • Responsible for championing local stakeholders and tactical decision-makers.
  • Suggests and develops high quality, high value concept and or process improvement and efficiency recommendations.
  • Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions.

Minimum Requirements:

Requires a BA/BS and minimum of 5 years experience in project/program management, process reengineering, organizational design, and/or implementation; or any combination of education and experience, which would provide an equivalent background. Travels to worksite and other locations as necessary.

Preferred Skills, Capabilities and Experiences:

Preferred experience includes a minimum of 5-7 years of inpatient coding or DRG auditing experience, including 2-3 years in a leadership or supervisory capacity.

Experience working with ICD-9/10CM, MS-DRG and APR-DRG.

Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $115,020 to $207,216

Locations: Maryland; Cleveland, OH; Columbus, OH; New Jersey, New York and Virginia.

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

Job Level: Manager

What Elevance Health employees say

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

Social media

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