Coding Quality Specialist I

Description

Summary :

CHRISTUS Health System offers the CodingQuality Specialist I position as a remoteopportunity. Candidate must reside in the states of Texas,Louisiana, Arkansas, New Mexico, or Georgia to further beconsidered for this position.*

The Coding QualitySpecialist reports to the HIM Coding Education Manager to performinternal departmental coding reviews in support of the CodingOperations Department’s business needs.

This position contributesto coding education and training and facilitates pre-bill andcross-training in order to advance and keep current, the skillsetof our HB coding associates.

The Coding QualitySpecialist demonstrates high caliber specialty knowledge andunderstanding of current ICD-10-CM, ICD-10-PCS and / or CPT / HCPCScoding guidelines and practices in both the inpatient andoutpatient care settings, maintaining a 95% accuracy rate.

Assignments are based on departmental needs and include butare not limited to PEPPER reviews, new hire and standard pre-billreviews, remediation and performance improvement reviews and thoserequired for corrective action plans, query quality and otherfocused reviews as may be needed.

The Coding Quality Specialistswill review for quality in regards to POA assignment, principal andsecondary diagnosis code assignment, procedural coding, modifierusage, discharge disposition verification, query opportunities andDRG and APC accuracy.

Coding Quality Specialist willwork collaboratively with various CHRISTUS Health Departments,including but not limited to the Regional Coding Managers, HIM,Compliance, and Clinical Documentation Specialist to ensurefeedback is shared and reported for education and trainingpurposes.

The Coding Quality Specialist will also assist inproduction coding as may be required and in order to keep currentskills up-to-date and accustomed to changing technology andworkflows.

The Coding Quality Specialist will reportdirectly to the HIM Coding Education Manager, with additionalleadership from the Director of Coding Operations and System HIMDirector.

Responsibilities :

• Facilitate and complete inpatient andoutpatient coding reviews.
• Communicatesfindings both verbally and in writing in an approved, appropriateformat to support training and education such as would be reportedin Coding Roundtables or Section Meetings.
• Assist with development and coordination ofreview plans, feedback to coding staff and management to includequery opportunities, documentation opportunities, accurate codeassignment (ICD, CPT, HCPCS), accurate payment groupings (DRG,APC), accurate modifier assignment, accurate POA assignment,accurate discharge disposition assignment, compliance and datamanagement.
• Assist with chart sample selectionfor reviews and randomization to be coordinated with CodingManagers.
• Assist with finalizing an annualwork plan for targeted chart reviews and pre-bill reviews.
• Work collaboratively with Coding IntegrityDepartment to recommend and assist with content and examples thatmay be used to develop Job Aides, Coding Best Practice referencesand other assisting resources to support and advance coderknowledge and expertise.

Reviews results and performs trendanalyses to identify patterns and variations in coding practicesand / or case-mix index which require education.

• Meets or exceeds an accuracy rate of 95%.
• Ensure coding reviews are appropriate andeffective. Assesses effectiveness through associate evaluations.
• All other work duties as assigned byManager.

Requirements :

• High school diploma or GED.
• Completion of accredited Baccalaureate HealthInformatics or Health Information Management or an AHIMA approvedCoding Certificate Program, preferred.
• Strongwritten and verbal communication skills.
• Ableto work independently in a remote setting, with minimalsupervision.
• Five (5) or more years ofInpatient and / or Outpatient HB coding experience in an acute caresetting
• Registered Health InformationAdministrator (RHIA) (AHIMA)
• Registered HealthInformation Technician (RHIT) (AHIMA) Certified Coding Specialist(CCS) (AHIMA)

WorkType : Full Time

Full Time

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