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Professional Fee Coding Data Integrity Specialist

4 weeks ago

Philadelphia, Pennsylvania, United States Pennsylvania Medicine Full time

Penn Medicine is a leading academic medical center dedicated to providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine.

The Professional Fee Coding Data Integrity Specialist is responsible for validating data to further research and identify the root cause of data trends in coding and auditing performance.

Responsible for supplying accurate data research, analysis, and verification to support CFA team strategy decisions as well as education to providers, leadership, coders, and auditors.

As a content expert, the Specialist keeps the health system leadership abreast of the latest coding trends, the reasons why the data is trending the way it is, and regularly communicates any potential coding quality issues.

The Specialist oversees coding denials and appeals in collaboration with the compliance and revenue cycle departments.

Incumbent interacts with HIM, IT Revenue Cycle, clinical practices, and other department personnel to support the communication and education of analyzed data.

Equips Provider Liaison with data and insights to facilitate proactive communication to clinical stakeholders.

Stays abreast of coding and auditing changes and trends in the healthcare industry.

Researches complicated coding issues and develops the team and organization's point of view.

Lends subject-matter expertise to develop robust coding and auditing education.

Provides education and training to CFA staff regarding coding risk and opportunities to avoid risk.

Documents and stores communications for future reference.

Supports Provider Liaison with research and interaction with clinical documentation improvement and Compliance.

Supports Provider Liaison and coding education with subject matter expertise details for coding and auditing growth.

Works with Director to develop and refine policies and procedures.

Responsible to timely and effectively communicate education and training needs of the CFA department, practices, and providers.

Ensures the PennChart application is functioning at an optimum capacity to support CFA coding and auditing.

Assesses additional software used by the CFA team to ensure effective and optimal use by the CFA team.

Provides professional-fee coding and auditing expertise to PennChart & IS teams; works with IS on testing and refinement of technologies.

Bachelor of Arts or Science (Required)

~ And 2+ years Previous work experience coding inpatient and outpatient medical records

Education Specialization:

Health Information Management or related field (required)

~1+ years experience in data validation, root cause analysis, and data analytics (required)

~ Our employee benefits programs help our employees get healthy and stay healthy.

Together we will continue to make medical advances that help people live longer, healthier lives.

Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.