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.