Remote CDQA Analyst: Coding Compliance & Audits

Presbyterian Healthcare Services; New Mexico; Remote; USD 27,000 - 44,000; Full time

Job summary

Presbyterian Healthcare Services in the United States (Remote NM) seeks an Administrative Analyst to support the Enterprise-Wide Coding team. Responsibilities include maintaining coding policies, coordinating audits, tracking results, and assisting with enterprise-wide training and remediation actions.

The role requires a High School diploma/GED and 1 year of healthcare coding/auditing experience, strong communication skills, and knowledge of ICD-9/10, CPT-4 and HCPCS.

Qualifications

• High school diploma/GED required.
• One year healthcare clinical, coding, auditing, compliance or patient financial services related experience.
• Excellent written and verbal communication skills.
• Detail and results oriented.
• Ability to work independently.
• Medical terminology, ICD-9/10, CPT-4 and HCPCS knowledge required.

Responsibilities

• Liaison to the Manager, Information Services, Finance/Patient Financial Services, all hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and all ancillary departments in addressing functional coding, auditing, compliance and training issues and problems.
• Maintain accurate, complete and timely documentation in electronic or hard copy form; stay updated on regulatory information related to coding and billing.
• Research regulatory agency regulations; identify and implement corrective action plans to ensure compliance; respond to inquiries regarding coding and auditing issues.
• Analyze data from audits and assist in providing recommendations to address business issues for a specific group; document responses and resolutions to inquiries.

Skills

Healthcare coding

Auditing

Regulatory compliance

Medical terminology

Education

High school diploma/GED

Job description

Presbyterian Healthcare Services in the United States (Remote NM) seeks an Administrative Analyst to support the Enterprise-Wide Coding team. Responsibilities include maintaining coding policies, coordinating audits, tracking results, and assisting with enterprise-wide training and remediation actions.

The role requires a High School diploma/GED and 1 year of healthcare coding/auditing experience, strong communication skills, and knowledge of ICD-9/10, CPT-4 and HCPCS.