Healthcare Coding Quality Analyst

2 weeks ago


Dallas, Texas, United States Children's Health Full time
Position Title & Specialty Area: Coding Quality Analyst III

Department: Coding and CDI

Location: Remote

Schedule: Monday - Friday 8am - 4:30pm

Why Choose Children's Health?
At Children's Health, our mission is to enhance the lives of children, recognizing that their health is pivotal to achieving this vision.

Through innovative treatments and our partnership with UT Southwestern, we aim to provide an exceptional experience for patients and their families, ensuring that every moment contributes positively to their well-being.

Our commitment to children's health transcends our organization, impacting the wider community. Together, we can significantly improve the lives of children and foster a healthier future for all.

Overview:

The Coding Quality Analyst is responsible for demonstrating extensive knowledge and expertise in the application of International Classification of Diseases and Procedures (ICD) and Current Procedural Terminology (CPT).
This role involves conducting medical record coding and documentation assessments for various encounters, including inpatient, observation, ambulatory surgery, emergency department, and other outpatient services. The analyst provides coding education based on review outcomes, serves as a resource for coding staff, leadership, and providers, and aids in developing action plans to address identified coding and documentation challenges. Additionally, this position offers ongoing training to coders, leadership, providers, and other organizational personnel, while supporting Clinical Documentation Improvement and Coding Leadership with research on coding and billing practices, statistical analysis, and reporting as required.

Key Responsibilities:
* Conducts coding and billing reviews for inpatient, observation, ambulatory surgery, emergency department, and other outpatient encounters, ensuring compliance and accuracy in coding and billing practices.

* Provides initial coding and documentation training and orientation for new coders and providers.

* Engages in activities related to annual code updates, including assessing impacts on coding and providers, testing system upgrades, creating training materials, and delivering training to staff and providers as necessary. This role requires the ability to research and respond to billing requirements from multiple payers.

Qualifications for Success:

WORK EXPERIENCE
  • Minimum of five years of progressive experience in inpatient and outpatient coding or coding review, including claims processing and data management responsibilities.
  • Thorough understanding of AHA and CMS coding guidelines, CPT/HCPCS, and ICD-10-CM/PCS coding systems, as well as NCCI and LCD edits.
  • Proficient in PC usage, with a functional knowledge of facility EMR, encoder, and other supportive software.
  • Experience in academic teaching and pediatric healthcare settings.
EDUCATION
* High school diploma or equivalent required.
* Two-year associate degree or equivalent experience preferred.
* Four-year bachelor's degree or equivalent experience preferred.

CERTIFICATIONS AND LICENSES
* Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS) required.
* Clinical Documentation Improvement Practitioner (CDIP) or Certified Clinical Documentation Specialist (CCDS) preferred.

A Culture of Belonging

We prioritize our people. We embrace, value, and respect the diverse beliefs, identities, and experiences of our patients and colleagues. Our commitment is to provide culturally effective care, foster meaningful partnerships within the communities we serve, and empower our team members to contribute to making Children's Health a welcoming environment for everyone.

Comprehensive Benefits - How We Support You:
Employee contributions to medical plan premiums are covered after three years.
4%-10% employee savings plan match based on tenure.
Paid Parental Leave (up to 12 weeks).
Caregiver Leave.
Adoption and surrogacy reimbursement.

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