CODING QUALITY EDUCATION ANALYST - HIS CODING DEPT
Full-time position.
Experience: 2+ to 5 years.
Qualifications: Associates Degree in Health Information Services or related field, or 3 years of coding experience.
Minimum Experience Requirements:
- Required: 3 years coding experience in an acute care setting.
- Preferred: 2 years performing coding and documentation audits.
Certifications: Must possess or be able to obtain RHIA, RHIT, CCS, or CPC within 12 months after hire.
Minimum Skill Requirements:
- Proficient in software applications (Excel, Word, 3M, SLH, Care Connect, Invision).
- Thorough knowledge of ICD9-CM and CPT.
- Expert in coding conventions and automated encoders, including knowledge of NCCI/OCE billing edits.
- Knowledgeable in DRG methodologies and regulatory/payer requirements.
- Ability to apply coding policies and procedures effectively.
- Strong time management, organizational, communication, decision-making, and problem-solving skills.
- Personal initiative to stay updated with coding developments, technology, and regulations.
- Successful completion of ICD 10 training (Certificate from AHIMA Academy).
Job Duties & Responsibilities:
- Assess accuracy of MSDRG, APRDRG, and APC assignments.
- Ensure proper identification, coding, and sequencing of diagnoses and procedures.
- Validate coding of diagnoses to confirm medical necessity.
- Utilize query tools appropriately.
- Maintain tracking and trending data in databases.
- Review audits with coders and coordinate re-billing as needed.
- Monitor coder error trends and report to management.
- Identify documentation issues and submit to denials management.
- Review records flagged for HARMS and reconcile discrepancies.
- Provide coding review summaries to management.
- Maintain review accuracy of at least 95%.
- Perform reviews meeting established standards.
- Provide feedback to coders and respond to requests for assistance.
- Deliver performance data to management for evaluations.
- Identify and advise on trend patterns and develop action plans.
- Assist in developing and updating coding procedures.
- Participate in coder interviews and training.
- Contribute to educational initiatives for physicians and staff.
- Participate in committees and cross-functional teams.
- Support weekly DNFB processes and provide backup coverage.
- Adjust workload based on staffing and volume changes.
- Monitor and resolve DRG review queues.
- Assist with code verification, charges, and denials review.
- Monitor coder productivity and resolve ITS issues.
- Perform other duties as assigned.
Skills & Certifications:
- Associates Degree in Health Information Services or related field, or 3 years coding experience.
- Must obtain RHIA, RHIT, CCS, or CPC within 12 months of hire.
Ideal Candidate:
- Associates Degree in Health Information Services.
- 3 years coding experience in an acute care setting.
- 2 years experience in coding and documentation audits.
- Thorough knowledge of ICD-10.
All information will be kept confidential according to EEO guidelines.
Direct Staffing Inc.