Are you seeking a stable and growth-oriented career path within the healthcare sector? The field of medical coding is experiencing significant demand, offering professionals the opportunity to utilize their analytical skills and medical knowledge in a dynamic environment. Companies like Gainwell Technologies are at the forefront, providing exciting roles that not only contribute to the efficiency of healthcare systems but also offer excellent work-life balance and career progression.
Gainwell Technologies, a leader in healthcare solutions, understands the critical role of accurate medical coding in today’s complex healthcare landscape. They are actively seeking talented individuals to join their team and contribute to innovative solutions. One such opportunity is the Nurse Coder – Product Specialist position, which exemplifies the rewarding nature of a career in medical coding.
Your Mission: Shaping the Future of Clinical and Coding Products
As a Nurse Coder – Product Specialist at Gainwell, you will be instrumental in the development and enhancement of clinical and coding products. This role is not just about coding; it’s about innovation and problem-solving. You will be a Subject Matter Expert (SME), lending your expertise to the clinical organization and innovation teams.
Key Responsibilities:
- Content Development: Collaborate with Medical Directors and Innovation Teams to create cutting-edge clinical and coding products. Develop innovative strategies to improve claim selection processes, directly impacting payment integrity for clients.
- Data Analysis and Innovation: Utilize your data analysis skills to drive innovation, including the development of Itemized Bill Review (IBR) concepts. Conduct research and analysis to refine coding and clinical targets and edits.
- Claim Selection Expertise: Apply your deep understanding of claim selection methodologies to enhance strategies, particularly for inpatient claims.
- Performance Monitoring: Track and analyze the performance of both existing and new programs, presenting your findings to clinical leadership and recommending data-driven improvements.
- Solution Enhancement: Leverage your expertise to contribute to the improvement and review of clinical and coding solutions, ensuring they remain at the forefront of industry standards.
- Product Implementation: Work with a diverse team to guide clinical and coding concepts from initial creation to successful implementation.
- Regulatory Compliance: Stay ahead of the curve by monitoring regulatory updates and adapting rules to maintain effectiveness and compliance.
- Analytical Problem-Solving: Employ your analytical skills to identify trends, troubleshoot issues, and implement effective action plans.
- Documentation and Standardization: Develop clear departmental policies, processes, and training standards to ensure consistency and quality.
- Clinical and Coding Expertise: Create clinical and coding content that informs decision-making for Clinical Services, Quality, and Appeals teams.
- SME Support: Serve as the primary SME for Gainwell’s clinical and coding programs, providing crucial support to account management, sales, clients, and internal clinical teams.
- Client and Sales Collaboration: Provide SME support for RFPs and engage with clients to explain programs, address concerns, and proactively develop solutions.
Are You the Ideal Candidate?
Gainwell Technologies is looking for individuals with a strong foundation in medical coding and a passion for making a difference in healthcare.
Essential Qualifications:
- Extensive Coding Experience: 10+ years of experience in reviewing and/or auditing ICD-10 CM/PCS, MS-DRG, APR DRG claims, with proficiency in encoder products. Experience with APC and EAPG is highly desirable.
- Required Certifications: Inpatient Medical Coding Certification (CCS, CIC, RHIA, RHIT) is mandatory. CPC with inpatient coding experience may also be considered. RN with coding credentials is a plus.
- Regulatory Knowledge: Proven ability to research and interpret State and Federal regulations, clinical policies, and coding guidelines to develop and implement effective policies and resources.
- Itemized Bill Review Expertise: Specific expertise in Itemized Bill Review (IBR) products is crucial for solution development and enhancement.
- Subject Matter Expertise: Deep understanding of inpatient and outpatient billing and coding audits, with the ability to provide SME-level support.
What to Expect in Your Career at Gainwell
Gainwell Technologies offers not just a job, but a fulfilling career path. They prioritize employee well-being and professional development.
Benefits and Work Environment:
- Full-Time, Stable Employment: This is a permanent, full-time salaried (W-2) position with a consistent Monday to Friday work schedule (40 hours per week).
- Career Growth: Upward career advancement is actively encouraged, providing ample opportunities for professional growth.
- Comprehensive Benefits: Health (medical, dental, vision) and paid time off benefits are effective from your first day of employment.
- Retirement Savings: Company match 401K and other benefits become available within months of joining.
- Company Resources: A company-provided computer ensures you have the tools you need to succeed.
- Remote Work Flexibility: This position offers remote work options, promoting work-life balance. Reliable Broadband Internet is required for remote positions.
- Professional Development: Access to leadership and technical development academies to continuously build your skills and capabilities.
Gainwell Technologies values its employees and fosters a diverse, equitable, and inclusive workplace. They are an Equal Opportunity Employer, committed to creating an environment where everyone can thrive.
If you are a medical coding professional looking for a challenging and rewarding career, Gainwell Technologies offers an exceptional opportunity. Join a company that is shaping the future of healthcare and invest in your career growth.
Explore this opportunity and other open roles at Gainwell Technologies’ Careers site. Learn more about Gainwell at their company website.
