Coding Quality Analyst

6 days ago

Corpus Christi, Texas, United States DRISCOLL HEALTH PLAN Full time
Where compassion meets innovation and technology and our employees are family.

Thank you for your interest in joining our team Please review the job information below.

Work on CBO PB Audits, assist with physician education, provide support to PB coders and Coding Manager.

General Purpose of Job:

Ensures that coding compliance initiatives are met with all record types.  Reviews and analyzes medical records and abstracted data submitted by the coding staff to determine the accuracy of code assignment and adequacy of clinical documentation according to regulatory requirements.  Performs frequent internal reviews and education maintenance long-term to ensure accuracy in the ever-changing environment of coding, documentation, quality initiatives, and impact to reimbursement.  Is able to code, train, and educate on all types of medical records in order to provide timely coverage in all coding areas helping to ensure accuracy, stability, and efficiency in our revenue cycle.

Essential Duties and Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Maintains utmost level of confidentiality at all times.
  • Adheres to hospital policies and procedures.
  • Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines. 
  • Successfully perform coding quality reviews to validate correct coding and abstracting.
  • Provide feedback to coding staff regarding audit results.
  • Provide cross-training support to the Lead Coder in areas where coding compliance is not met.
  • Provide quality reviews as requested from other departments such as Case Management, Quality, and Patient Financial Services
  • Assist with statistical validation for external reporting entities such as STS, THCIC, and CHA
  • Ensure accuracy and optimization of quality initiatives such as Potentially Preventable Events, ICD-10, Data Governance, and future initiatives.
  • Maintain ongoing communication with management, CDI, and coding staff to ensure coding compliance goals are met.
  • Assist HIM management in performing coder education tasks and new employee orientation.
  • Prepare QA coding reports.
  • Assist HIM management in the analysis of QA coding reports.

Education and/or Experience:

  • Associate's degree (A. A.) or equivalent from two-year college or technical school; or two to three years related experience and/or training; or equivalent combination of education and experience.
  • Bachelor's degree (B. A.) from four-year college or university; or two to three years related experience and/or training; or equivalent combination of education and experience.

Certificates, Licenses, Registrations.

  • RHIA or RHIT optional.
  • CCS/CCS-P/CPC required.

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