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Coding Quality Specialist
2 months ago
The Coding Quality Specialist position at CHRISTUS Health is a remote opportunity that requires residing in specific states. The successful candidate will report to the HIM Coding Education Manager and contribute to coding education and training, facilitating pre-bill and cross-training to advance the skillset of HB coding associates. This role involves high-caliber specialty knowledge and understanding of current coding guidelines and practices, maintaining a 95% accuracy rate. Assignments include PEPPER reviews, new hire and standard pre-bill reviews, remediation and performance improvement reviews, and other focused reviews as needed. The Coding Quality Specialist will review for quality in regards to POA assignment, principal and secondary diagnosis code assignment, procedural coding, modifier usage, discharge disposition verification, query opportunities, and DRG and APC accuracy. This role requires collaboration with various CHRISTUS Health Departments, including Regional Coding Managers, HIM, Compliance, and Clinical Documentation Specialist, to ensure feedback is shared and reported for education and training purposes. The Coding Quality Specialist will also assist in production coding as required and keep current skills up-to-date with changing technology and workflows. The successful candidate will report directly to the HIM Coding Education Manager, with additional leadership from the Director of Coding Operations and System HIM Director. Responsibilities:
Meet expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Facilitate and complete inpatient and outpatient coding reviews. Communicate findings both verbally and in writing in an approved, appropriate format to support training and education. Assist with development and coordination of review plans, feedback to coding staff and management, including query opportunities, documentation opportunities, accurate code assignment, accurate payment groupings, accurate modifier assignment, accurate POA assignment, accurate discharge disposition assignment, compliance, and data management. Assist with chart sample selection for reviews and randomization to be coordinated with Coding Managers. Assist with finalizing an annual work plan for targeted chart reviews and pre-bill reviews. Work collaboratively with Coding Integrity Department to recommend and assist with content and examples that may be used to develop Job Aides, Coding Best Practice references, and other assisting resources to support and advance coder knowledge and expertise. Reviews results and performs trend analyses to identify patterns and variations in coding practices and/or case-mix index which require education. Meet or exceed an accuracy rate of 95%. Ensure coding reviews are appropriate and effective. Assess effectiveness through associate evaluations. Has strong written and verbal communication skills. Able to work independently in a remote setting, with minimal supervision. All other work duties as assigned by Manager. Requirements:
High school diploma or equivalent years of experience required. Completion of accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred. Five (5) or more years of Inpatient and/or Outpatient HB coding experience in an acute care setting preferred. Registered Health Information Administrator (RHIA) (AHIMA) required. Registered Health Information Technician (RHIT) (AHIMA) required. Certified Coding Specialist (CCS) (AHIMA) required.
