Coding Quality Review Specialist

General Summary of Position

Performs coding quality reviews on medical records.

• Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
• Assists with the development of system-specific coding guidelines as needed, and participates in Quality review team meetings.
• Having knowledge of coding compliance plan, directs efforts to achieving plan by focusing on areas identified through coding reviews or targeted by management for improvement.
• Helps select areas for focused quality reviews.
• Maintains continuing education. Maintains credentials, for required job classification.
• Meets established Quality, Accuracy, and Productivity standards as defined by policies.
• Provides/identifies trends to provide feedback to appropriate sources. Identifies and assists in areas to provide additional training/education, under the direction of Manager.
• Responsible for retrospective and concurrent reviews on coding staff.
• Reviews, analyzes, and interprets medical record documentation to identify diagnoses and procedures. Assigns correct ICD and/or CPT diagnostic and procedural codes using standard guidelines and automated encoding software. Assigns the appropriate DRG.
• Works closely with the Coding Quality Review team and outpatient coding staff to identify areas for improvement and problematic cases.
• Participates in multi-disciplinary quality and service improvement teams.

• High School Diploma or GED required ;
  Bachelor's degree with successful completion of medical terminology, anatomy, physiology, and coding courses in ICD-10-CM and CPT-4 preferred.

• 2 years inpatient coding experience, preferably in an acute care setting required; 1-2 years Auditing experience preferred.

• CCS (Certified Coding Specialist) through AHIMA required.
• Certification as a Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) preferred.

• Excellent verbal and written communication skills.
• Excellent interpersonal skills, Good public speaker and presenter.
• Basic computer skills preferred.

This position has a hiring range of $30.67 - $54.48.