Coding Educa & Quality Analyst

OhioHealth

2d

About The Position

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities. Job Description Summary: This position performs facility and charge entry audits of all Hospital, Neighborhood Care, Vascular Interventional Radiology, Rehab and clinic coding records. This includes inpatient, outpatient, observation, emergency department, vascular interventional radiology diagnostic and clinic service lines. The Education and Quality Analyst educates physicians, coders, failed claims specialists and clinical documentation specialists on coding, vascular interventional radiology, billing, clinical documentation and coding compliance. They are also responsible for interacting with medical staff for all coding queries for all Central Ohio Hospitals. When necessary, this position also performs statistical reporting involving CDI activities and other related tasks. The Coding Education and Quality Analyst helps to ensure coding and billing for patient services are in compliance with rules and regulations for participation in governmental programs as well as meeting the contractual obligations of non-governmental payers. This position is also responsible for preparing and sending responses to audits performed by third parties such as insurance companies. This position appraises the quality and productivity of new hires and coders they conduct quality monitoring on. The quality monitoring will be shared with coding management for potential work improvement plans.

Requirements

• Associate's Degree (Required)
• CCS - Certified Coding Specialist - American Health Information Management Association
• CCSP - Cisco Certified Security Professional - CISCO - Computer Information System Company
• CPC - CPC Certified Professional Coder - AAPC American Academy of Professional Coders
• CPCH - Certified Professional Coder - Hospital - AAPC American Academy of Professional Coders
• RHIA - Registered Health Information Administrator - American Health Information Management Association
• CCS - CCS
• CCSP - CCSP
• CPC - Certified Professional Coder
• CPCH - Certified Professional Coder - Field of Study: Coding
• Years of Experience 3

Responsibilities

• Documentation Audit This position conducts facility and charge entry audits of all Hospital, Neighborhood Care, Vascular Interventional Radiology, Rehab and clinic coding records. This includes inpatient, outpatient, observation, emergency department, vascular interventional radiology diagnostic and clinic service lines. Works with Clinical Documentation Improvement staff and Data Quality Engineers to ensure accurate capture and reporting of Hospital and Physician Quality Indicators for external reporting purposes. Monitors and tracks PQRI reports as applicable to individual practitioners and Operations staff. Reviews MediRegs, research of federal regulations, coding rules and regulations, and other reference material. Communicates coding and compliance updates to appropriate staff including physicians and management as appropriate. Assists Coding Management and Failed Claims with resolution of unbilled and billed claim rejections related to coding and documentation as well as other facility departments regarding coding and charge issues as applicable. Ensures encounter forms are updated and compliant.
• Education The Education and Quality Analyst educates physicians, coders, failed claims specialists and clinical documentation specialists on coding, vascular interventional radiology, billing, clinical documentation and coding compliance. Communicates coding and compliance updates to all coding staff and failed claims. Also educates other departments and individuals as necessary regarding coding rules, documentation guidelines and charge issues. Will be primarily responsible for ICD-10 CM/PCS education for entire OhioHealth System.
• Physician Queries Responsible for interacting with medical staff for all coding queries for all Central Ohio Hospitals.
• Policy and Procedural Development/Other Duties Assists in development of policies and procedures crossing multiple department lines. All other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree