Coding Education & Quality Analyst

OhioHealth; Ohio; Hybrid; USD 70,000 - 100,000; Full time

Job summary

OhioHealth is seeking an Education and Quality Analyst to conduct professional coding audits across inpatient, outpatient, observation, emergency department and OhioHealth Physician Group clinic lines. The role educates physicians and coders on coding, billing, and documentation compliance, and partners with staff to address coding queries.

You will help ensure compliance with government programs and payer contracts, prepare responses to third-party audits, and support performance improvement

Qualifications

• High School or GED is required.
• CCS - Certified Coding Specialist (AHIMA) credential.
• CCSP - Cisco Certified Security Professional.
• CPC - Certified Professional Coder (AAPC).
• CPCH - Certified Professional Coder (AAPC).
• RHIA - Registered Health Information Administrator (AHIMA).

Responsibilities

• Audit facility and charge entries across Hospital, Neighborhood Care, Vascular Interventional Radiology, Rehab and clinic coding records.
• Educate physicians, coders, failed claims specialists and clinical documentation specialists on coding, billing, documentation and compliance.
• Interact with medical staff for coding queries for all Central Ohio Hospitals.
• Assist in development of policies and procedures across departments and support improvement initiatives.

Education

High School or GED

CCS - Certified Coding Specialist

CCSP - Cisco Certified Security Professional

CPC - Certified Professional Coder

CPCH - Certified Professional Coder - Hospital

RHIA - Registered Health Information Administrator

Job description

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities.

Job Description Summary

This position conducts professional coding audits of clinical coding records across inpatient, outpatient, observation, emergency department, and all OhioHealth Physician Group (OPG) clinic service lines. The Education and Quality Analyst provides education to physicians, coders, failed claims specialists, and clinical documentation specialists regarding coding, billing, clinical documentation, and coding compliance. The analyst also collaborates with medical staff to address coding queries across all OPG clinic service lines. In addition, the Coding Education and Quality Analyst helps ensure that coding and billing for patient services comply with governmental program requirements and the contractual obligations of non-governmental payers. This position is also responsible for preparing and submitting responses to third-party audits, including those conducted by insurance companies. The analyst evaluates the quality and productivity of new hires and coders who are subject to quality monitoring. Quality-monitoring results are shared with coding management to support performance improvement efforts and, when appropriate, the development of work improvement plans.

Responsibilities And Duties

• 40% Documentation Audit This position conducts facility and charge entry audits of all Hospital, Neighborhood Care, Vascular Interventional Radiology, Rehab and clinic coding records. This includes inpatient, outpatient, observation, emergency department, vascular interventional radiology diagnostic and clinic service lines. Works with Clinical Documentation Improvement staff and Data Quality Engineers to ensure accurate capture and reporting of Hospital and Physician Quality Indicators for external reporting purposes. Monitors and tracks PQRI reports as applicable to individual practitioners and Operations staff. Reviews MediRegs, research of federal regulations, coding rules and regulations, and other reference material. Communicates coding and compliance updates to appropriate staff including physicians and management as appropriate. Assists Coding Management and Failed Claims with resolution of unbilled and billed claim rejections related to coding and documentation as well as other facility departments regarding coding and charge issues as applicable. Ensures encounter forms are updated and compliant.
• 35% Education The Education and Quality Analyst educates physicians, coders, failed claims specialists and clinical documentation specialists on coding, vascular interventional radiology, billing, clinical documentation and coding compliance. Communicates coding and compliance updates to all coding staff and failed claims. Also educates other departments and individuals as necessary regarding coding rules, documentation guidelines and charge issues. Will be primarily responsible for ICD-10 CM/PCS education for entire OhioHealth System.
• 15% Physician Queries Responsible for interacting with medical staff for all coding queries for all Central Ohio Hospitals.
• 10% Policy and Procedural Development/Other Duties Assists in development of policies and procedures crossing multiple department lines. All other duties as assigned.

Minimum Qualifications

• High School or GED (Required)
• CCS - Certified Coding Specialist - American Health Information Management Association
• CCSP - Cisco Certified Security Professional - CISCO - Computer Information System Company
• CPC - CPC Certified Professional Coder - AAPC American Academy of Professional Coders
• CPCH - Certified Professional Coder - Hospital - AAPC American Academy of Professional Coders
• RHIA - Registered Health Information Administrator - American Health Information Management Association

Additional Job Description

• CCS - CCS CCSP - CCSP CPC - Certified Professional Coder CPCH - Certified Professional Coder - Field of Study: Coding Years of Experience 3 Work Shift: Day Scheduled Weekly Hours : 40 Department Physician Coding

Join us! … if your passion is to work in a caring environment … if you believe that learning is a life-long process … if you strive for excellence and want to be among the best in the healthcare industry

Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment

Remote Work Disclaimer

Positions marked as remote are only eligible for work from Ohio.

WE Are Inspired to Do Our Best. OhioHealth is a nationally recognized, innovative healthcare system delivering world-class patient care in a supportive, professional environment filled with limitless opportunities to learn and grow. We are a unique organization in the healthcare field. Our model system of facilities encompasses a wide scope of expertise and care. For professionals, we are a place where people committed to doing their best are given the tools and resources to accomplish our mission every single day. OhioHealth is recognized as a Great Place to Work CertifiedTM organization. The Great Place to Work® is a global authority on high-trust, high-performance workplace cultures. This recognition is one measure of our success in achieving a part of our vision - to be an organization 'where people want to work.'