Job Description
Job Title : Coding Quality Review Educator
Location : Oklahoma City, OK 73105
Shift : 7am – 4 : 30pm CST (Mon-Fri)
Duration : 6+ months (26 Weeks)
Pay rate : $35.00-40.00 / hr on W2
General Description :
- Performs internal quality assessment reviews on facility’s coders to ensure compliance with national coding guidelines and the facility’s coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity
- Helps to coordinate and direct the day-to-day coding educational activities
- Facilitates and provides coding educational classes / presentations to staff, as required / when needed
- Communicates outcomes to the coding team to improve the accuracy, integrity, and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments
- Responsibilities also include assisting Coding Leadership in root cause analysis of coding quality issues, performing account reviews, and preparing training documents to assist with coding quality action plans
Essential Responsibilities :
Inability to perform these responsibilities with or without an accommodation may result in disqualification from the positionResponds to coding-related questions from HSC coding staff Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven) for inpatient and outpatient coding across FacilityProvides Coding Integrity Specialist (CIS) and CQR education as neededInitiates the rebilling process as required per policy on special projectsResearches coding opportunities and escalate as neededAssists in the review, improvement of processes, education, troubleshooting and recommend prioritization of issuesProvides and creates education as neededMonitors QA results to assist Coding Leadership in root cause analysis and educational opportunitiesAssists with curriculum developmentAssists in ensuring coding staff adherence with coding guidelines and policy Demonstrates and applies expert level knowledge of medical coding practices and conceptsParticipates on special reviews or projectsMaintains or exceeds 95% productivity standardsMaintains or exceeds 95% accuracyMeets all educational requirements as stated in current Company policy Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical / medical resources to assure coding knowledge and skills remain current Performs an annual education needs assessment as input to the strategic coding education program and provides this assessment to the Coding Leadership teamCommunicates Coding topics and / or question trends to Coding Leadership for global educationCoaches and mentors coding staff as they develop and grow their coding skillsProvides skilled coding support through regularly scheduled coding meetings and as the need arisesResearch external sources for common coding trends and questionsWorks on special projects as assignedApplies adult learning concepts when developing, delivering or assisting others for educational programsProvides high level of customer service Practices and demonstrates adherence to the Company’s Code of Conduct and ethics philosophy and Company’s Mission and ValuesCompletes other duties as assignedSkills Required :
Coding Technical / Professional Knowledge and Skills : Extensive regulatory coding, (ICD-10-CM, ICD-10- PCS, CPT-4, Modifiers, MS-DRGs, POA assignment and where applicable APR-DRGs and APCs) and associated reimbursement knowledgeEffective Decision Making : Relating and comparing, securing relevant information and identifying key issues, committing to an action after developing alternative courses of action that take into consideration resources, constraints, and organizational values Adaptability to major changes in work responsibilities or environment; adjusting effectively to work within new work structures, processes, requirements, or culturesInitiative : independently takes prompt proactive steps toward problem resolution Contributing to Team Success by actively participating as a member of the team to move the team toward the completion of goalsWork Standards : Setting high standards of performance for self and others; assuming responsibility and accountability for successfully completing assignments or tasks, self- imposing standards of excellence rather than having standards imposedCommunication : Communicates clearly and concisely, verbally and in writingCustomer Orientation : establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectationsInterpersonal Skills : Able to work effectively with other employees, patients, and external partiesData Analysis : Able to analyze, interpret and share data in a presentation formatKnowledge of Healthcare Information : Familiar with various types and sources of health care information, including financial and patient level data filesWork Independently, with experience working in a team environmentPC Skills : Demonstrates proficiency in Microsoft Office applications and others as requiredPolicies & Procedures : Demonstrates knowledge and understanding of organizational policies, procedures, systems and query handbook.Education Required :
High School graduate or GED equivalent requiredUndergraduate (associates or bachelors) degree in HIM / HIT preferredExperience Required :
Proven work experience in areas of coding education strongly preferredMinimum of 5 years acute care inpatient / outpatient coding experience requiredMinimum of 3 years coding auditing / monitoring experience strongly preferredLicense(s) / Certification(s) / Registration(s) Required :
RHIA, RHIT, CCS, or CPC requiredAs a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.
Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.