Coding Quality Education Analyst - HIS Coding Department
Full-Time
No salary listed
Mid
Associate's
Arlington, TX, USA
In Person
About the job
Requirements
An Associate's Degree in Health Information Services or a related field, or three years of coding experience.
At least three years of coding experience in an acute care setting.
Proficiency in Excel, Word, 3M, SLH, Care Connect, and Invision.
Thorough knowledge of ICD-9-CM and Current Procedural Terminology.
Knowledge of coding conventions, automated encoders, NCCI/OCE billing edits, DRG methodologies, and regulatory and payer requirements associated with coding.
Knowledge of and ability to apply organizational coding policies and procedures to the record review process.
Ability to manage time, organize work, make decisions, solve problems, and communicate clearly in oral and written form.
Must possess or be able to obtain RHIA, RHIT, CCS, or CPC within 12 months after hire.
Successful completion of ICD-10 AHIMA Academy training and certificate-holder status.
Responsibilities
Assess the accuracy of MS-DRG, APR-DRG, and APC assignments.
Confirm the appropriate identification, coding, and sequencing of pertinent secondary diagnoses and procedures, including severity of illness.
Confirm the coding of all diagnoses required to validate medical necessity.
Validate the use or nonuse of the query tool.
Enter information into the database for tracking and trending.
Review audits with coders and coordinate with the CBO to rebill accounts as needed.
Monitor coder error trends and advise the appropriate manager of identified trends and patterns.
Identify issues related to clinical departments or physician documentation and submit them to denials management.
Review records identified for HARMS and reconcile discrepancies with the appropriate clinical department, Risk Management, Quality, and other stakeholders.
Provide coding review summary reports to management as required.
Provide feedback to employees on issues identified during record review, with supporting documentation as needed.
Respond promptly to coder requests for assistance.
Provide managers with quality and quantity performance data for use in performance reviews and provide input into staff evaluations.
Monitor review-process trends and advise the appropriate manager when individual action plans or section education may be needed.
Assist with developing action plans and implement them under manager oversight.
Assist in developing and updating procedures to maintain correct-coding standards.
Participate in coder interviews and administer coding skills tests.
Collaborate with education coordinators to train new coding employees.
Provide a monthly summary of review activities and findings to the Senior Analyst.
Provide input into the development, refinement, and implementation of methods and procedures used to complete review functions.
Contribute to educational and training opportunities for physicians and hospital clinical staff.
Participate in committee work and cross-functional teams as requested by department management.
Assist the manager with weekly DNFB processes to consistently meet entity and system targets and provide backup coverage for coding staff as needed.
Analyze and adjust workload responsibilities based on changes in staffing and volumes.
Monitor and resolve Stockamp QUIC queues related to DRG reviews according to schedule.
Assist with requests to verify and review codes, charges on patient accounts, and denials.
Assist the manager in monitoring and reporting coder productivity.
Assist coding staff in resolving ITS issues affecting work efficiency and facilitate ticket submission.
Perform other duties as assigned.
Desired Qualifications
Two years of experience performing coding and documentation audits.
An Associate's Degree in Health Information Services.
Thorough knowledge of ICD-10.
Job Description
CODING QUALITY EDUCATION ANALYST - HIS CODING DEPT
2+ to 5 years experience
Minimum Education Requirements:
Associates Degree in Health Information Services or related field or 3 years coding experience.
Minimum Experience Requirements:
Required - 3 years coding experience in an acute care setting.
Preferred: 2 years performing coding and documentation audits.
Minimum Licensure/Certification Requirements:
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 convention/automated encoder (knowledge management of NCCI/OCE billing edits); Knowledgeable in DRG methodologies and all regulatory/ payer requirements associated with coding. Demonstrates knowledge of and ability to apply THR coding policies and procedures to record review process. Demonstrates time management and organizational skills. Demonstrates clear and concise oral and written communication skills. Demonstrates strong decision making and problem solving skills; Personal initiative to keep abreast of new developments in coding
updates/technology/research/regulatory data; Successful completion of ICD 10-AHIMA Academy training: Certificate Holder
JOB DUTIES / RESPONSIBILITIES:
- Assesses accuracy of MSDRG, APRDRG and APC assignment
- Confirms appropriate identification, coding and sequencing of pertinent secondary diagnoses and procedures severity of illness, etc.
- Confirms coding of all diagnoses required to validate medical necessity.
- Validates the use or nonuse of the query tool.
- Responsible for entry into database for tracking and trending
- Reviews audit with coder and coordinates with the CBO to re-bill of accounts as needed.
- Monitors for coder error trends in reviews and advises appropriate manger of identified trends/patterns.
- Identifies issues that relate to the clinical department and/or physician documentation and submits to denials management.
- Reviews records identified for HARMS; reconciles discrepencies with appropriate clinical department, Risk Management, Quality etc.
- Provide coding review summary reports to management as required.
- Accuracy of reviews 95% standard (As validated by Senior Analyst audits)
- Quantity of reviews performed meet established standards
- Provides feedback to employee on identified issues found during record review with supportive documentation as needed
- Responds timely to coder requests for assistance.
- Provides manager with quality and quantity performance data for use in performance reviews. Provides input into staff evaluations.
- Monitors for trends during review process and advises appropriate manager of identified trends/patterns reflecting need for individual action plan(s) or section education.
- Assists with the development of actions plans and implements with the oversight of the manager.
- Assists in the development and updating of procedures to maintain standards for correct coding.
- Participates in the coder interviews and administers coding skill test.
- Collaborates with the education coordinators in the training of new coding employees.
- Provides monthly summary to Senior Analyst of review activities and findings.
- Provides input in the development, refinement and implementation of methods and procedures used to complete review functions.
- Contributes to the development of educational/training opportunities for physicians and hospital clinical staff
- Participates in committee work and cross functional teams as needed by department management.
- Assists manager with the processes associated with the weekly DNFB to consistently meet entity/system targets; provides back up coverage for coding staff as needed.
- Analyzes and adjusts workload responsibilities based on changes in staffing/volumes etc.
- Monitors and resolves the Stockamp QUIC queues pertaining to DRG reviews according to schedule.
- Assists with requests to verify and review codes; charges on patient accounts and denials.
- Assists manager in monitoring and reporting coder productivity.
- Assists coding staff in resolving ITS issues impacting work efficiently; facilitates ticket submission,
- Perform other duties as assigned
SKILLS AND CERTIFICATIONS
Associates Degree in Health Information Services or related field or 3 years coding experience
Must possess or be able to obtain RHIA, RHIT, CCS, or CPC within 12 months after hire
IDEAL CANDIDATE
Associates Degree in Health Information Services
3 years coding experience in an acute care setting
2 years performing coding and documentation audits
Thorough knowledge of ICD10
Qualifications
Additional Information
All your information will be kept confidential according to EEO guidelines.