Hospital Coding Quality Integrity Analyst - Outpatient

Aurora Health Care; Allenton (WI); Presencial; USD 80.000 - 110.000; Tempo integral

Resumo da vaga

Aurora Health Care seeks a senior coding professional to ensure accurate professional and hospital coding in a compliant, enterprise-wide framework.

The role focuses on developing coding guidance, conducting audits, and driving quality improvements across departments, with strong collaboration among clinicians and leadership. Remote-work experience is preferred, travel may be required.

Qualificações

• Advanced knowledge of ICD, CPT, and HCPCS coding guidelines.
• Advanced knowledge of medical terminology, anatomy, and physiology.
• Ability to analyze trends and data and display them in a statistical reporting format.
• Strong communication skills, both verbal and written.
• Experience with remote workforce operations.
• Proficiency with Microsoft Office, video and web conferencing, email, and EHR systems.

Responsabilidades

• Research, interpret, and apply coding, payer, and regulatory requirements to support accurate and compliant Professional and Hospital coding practices.
• Develop, maintain, and update coding guidance, standard work, reference materials, and position statements to ensure enterprise consistency.
• Coordinate and support coding quality audits by routing requests, maintaining records, and verifying documentation completeness and accuracy.
• Analyze coding quality data and audit results to identify trends, risks, and opportunities for improvement.
• Prepare summaries, reports, and materials for leadership, audit reviews, and quality improvement initiatives.
• Partner with Integrity Operations, coding leadership, clinicians, and education teams to improve documentation quality and coding accuracy.
• Support regulatory, compliance, and quality-related projects, ensuring adherence to organizational policies and AHIMA coding standards.
• Respond to internal inquiries related to coding guidance, quality findings, and audit outcomes.
• Support testing, reporting validation, and workflow updates related to coding quality, guidance, and compliance initiatives.

Conhecimentos

ICD CPT HCPCS guidelines

Medical terminology

Data analysis

Train others

EHR systems

Microsoft Office

Remote workforce operations

Formação

Associate degree

Ferramentas

EHR systems

Microsoft Office

Descrição da vaga

• Research, interpret, and apply coding, payer, and regulatory requirements to support accurate and compliant Professional and Hospital coding practices.
• Develop, maintain, and update coding guidance, standard work, reference materials, and position statements to ensure enterprise consistency.
• Coordinate and support coding quality audits by routing requests, maintaining records, and verifying documentation completeness and accuracy. Track audit findings, quality issues, and compliance risks, documenting patterns and supporting corrective actions.
• Analyze coding quality data and audit results to identify trends, risks, and opportunities for improvement.
• Prepare summaries, reports, and materials for leadership, audit reviews, and quality improvement initiatives.
• Partner with Integrity Operations, coding leadership, clinicians, and education teams to improve documentation quality and coding accuracy.
• Support regulatory, compliance, and quality-related projects, ensuring adherence to organizational policies and AHIMA coding standards.
• Respond to internal inquiries related to coding guidance, quality findings, and audit outcomes.
• Support testing, reporting validation, and workflow updates related to coding quality, guidance, and compliance initiatives.

Minimum Job Requirements

• Associate degree or equivalent education and experience required.

Major Responsibilities

• Research, interpret, and apply coding, payer, and regulatory requirements to support accurate and compliant Professional and Hospital coding practices.
• Develop, maintain, and update coding guidance, standard work, reference materials, and position statements to ensure enterprise consistency.
• Coordinate and support coding quality audits by routing requests, maintaining records, and verifying documentation completeness and accuracy. Track audit findings, quality issues, and compliance risks, documenting patterns and supporting corrective actions.
• Analyze coding quality data and audit results to identify trends, risks, and opportunities for improvement.
• Prepare summaries, reports, and materials for leadership, audit reviews, and quality improvement initiatives.
• Partner with Integrity Operations, coding leadership, clinicians, and education teams to improve documentation quality and coding accuracy.
• Support regulatory, compliance, and quality-related projects, ensuring adherence to organizational policies and AHIMA coding standards.
• Respond to internal inquiries related to coding guidance, quality findings, and audit outcomes.
• Support testing, reporting validation, and workflow updates related to coding quality, guidance, and compliance initiatives.

Minimum Job Requirements

Education

• Associate degree or equivalent education and experience required.

Certification / Registration / License

• Coding credentials required. Certification from American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) such as RHIA or RHIT or CCS, or CCS-P, or CPC.

Experience

• 5 years of experience in expert-level hospital-based outpatient coding and experience in revenue cycle processes, health information workflows, and medical record auditing experience.

Knowledge / Skills / Abilities

• Advanced knowledge of ICD, CPT, and HCPCS coding guidelines.
• Advanced knowledge of medical terminology, anatomy, and physiology. Advanced ability to identify coding quality issues/concerns and provide recommendations for improvement.
• Advanced ability to analyze trends and data and display them in a statistical reporting format.
• Advanced organization and communication (verbal and written) skills.
• Advanced ability to effectively train others through oral and/or written methods.
• Advanced organization, prioritization, and reading comprehension skills.
• Advanced analytical skills, with high attention to detail.
• Advanced knowledge of Microsoft Office, video and web conferencing, email, and experience with electronic coding and EHR systems or applications.
• Advanced knowledge of care delivery documentation systems and related medical record documents.
• Advanced interpersonal communication skills (oral and written) necessary to collaborate with Physicians, other clinicians, and Professional Coding Department team members and leadership.
• Ability to work independently and exercise independent judgment and decision-making.
• Ability to meet deadlines while working in a fast-paced environment.
• Ability to take initiative and work collaboratively with others.
• Ability to meet deadlines while working in a fast-paced environment.
• Strong sense of ethics.
• Experience with remote workforce operations required.

Physical Requirements And Working Conditions

• Position requires travel which will result in exposure to road and weather hazards.
• Operates the equipment necessary to perform the job.
• Exposed to a normal office environment.

Preferred Job Requirements

Preferred Certification / Registration / License

• Second Specialty credential preferred.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

EREMOTE