Full-Time
Coding Quality Education Analyst
Direct Staffing
No salary listed
Arlington, TX, USA
In Person
Category
 Medical, Clinical & Veterinary (1) |
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Required Skills
Word/Pages/Docs
Excel/Numbers/Sheets
Requirements
- Associates Degree in Health Information Services or related field or 3 years coding experience
- Required - 3 years coding experience in an acute care setting
- Must possess or be able to obtain RHIA, RHIT, CCS, or CPC within 12 months after hire
- 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
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
Desired Qualifications
- 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