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Coding Quality Assurance Analyst I
2 months ago
Overview:
*CHRISTUS Health System presents the Coding Quality Assurance Analyst I role as a remote opportunity. Candidates must reside in specific states to be considered for this position.* The Coding Quality Assurance Analyst reports to the HIM Coding Education Manager and is responsible for conducting internal departmental coding assessments to support the operational needs of the Coding Operations Department. This role plays a vital part in coding education and training, facilitating pre-bill and cross-training to enhance and maintain the expertise of our HB coding professionals.
The Coding Quality Assurance Analyst showcases exceptional specialty knowledge and comprehension of current ICD-10-CM, ICD-10-PCS, and/or CPT/HCPCS coding standards and practices in both inpatient and outpatient care environments, achieving a minimum accuracy rate of 95%.
Responsibilities are determined by departmental requirements and encompass, but are not limited to, PEPPER reviews, new hire and standard pre-bill assessments, remediation and performance enhancement reviews, and those necessary for corrective action plans, query quality, and other focused evaluations as needed.
The Coding Quality Assurance Analyst will evaluate quality concerning POA assignment, principal and secondary diagnosis code assignment, procedural coding, modifier application, discharge disposition verification, query opportunities, and DRG and APC accuracy.
This position will collaborate with various CHRISTUS Health Departments, including but not limited to Regional Coding Managers, HIM, Compliance, and Clinical Documentation Specialists to ensure that feedback is communicated and documented for educational and training purposes.
Additionally, the Coding Quality Assurance Analyst may assist in production coding as required to maintain current skills and adapt to evolving technology and workflows.
The Coding Quality Assurance Analyst will report directly to the HIM Coding Education Manager, with further guidance from the Director of Coding Operations and System HIM Director.
Key Responsibilities:
Conduct and finalize inpatient and outpatient coding evaluations.
Effectively communicate findings both verbally and in writing in an approved format to support training and education, as would be presented in Coding Roundtables or Section Meetings.
Assist in the development and coordination of review plans, providing feedback to coding staff and management, including query opportunities, documentation enhancements, accurate code assignment (ICD, CPT, HCPCS), precise payment groupings (DRG, APC), correct modifier application, accurate POA assignment, and discharge disposition verification, compliance, and data management.
Support chart sample selection for reviews and randomization in coordination with Coding Managers. Aid in finalizing an annual work plan for targeted chart evaluations and pre-bill assessments.Collaborate with the Coding Integrity Department to recommend and assist in creating content and examples for Job Aides, Coding Best Practice references, and other resources to enhance coder knowledge and expertise.
Analyze results and perform trend analyses to identify patterns and variations in coding practices and/or case-mix index that necessitate education.
Maintain or exceed an accuracy rate of 95%. Ensure that coding evaluations are appropriate and effective, assessing their impact through associate evaluations. Perform all other duties as assigned by the Manager.Qualifications:
High school diploma or GED. Completion of an accredited Baccalaureate in Health Informatics or Health Information Management or an AHIMA-approved Coding Certificate Program is preferred. Strong written and verbal communication skills are essential. Ability to work independently in a remote environment with minimal supervision.
Five (5) or more years of Inpatient and/or Outpatient HB coding experience in an acute care setting. Registered Health Information Administrator (RHIA) (AHIMA) or Registered Health Information Technician (RHIT) (AHIMA) or Certified Coding Specialist (CCS) (AHIMA) certification is preferred. Work Type:
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