Coding Quality Analyst

Corewell Health • Grand Rapids, MI

1d • Onsite

About The Position

Acts as a liaison between physician practices, rehab services, professional billing office, coding, payer relations, compliance and revenue management operations of patient financial services and Corewell Health. Provides assistance to management and employees. Conducts coding quality reviews for the coding department, rehab services and physician practices.

Requirements

• Bachelor's Degree accounting, finance, health care administration, or related field or equivalent combination of education and experience
• 2 years of relevant experience progressive experience in various hospital functions (e.g., professional/facility coding, reimbursement, billing, and/or chargemaster maintenance
• CRT-Registered Health Information Administrator (RHIA) - AHIMA American Health Information Management Association Upon Hire required
• Or CRT-Registered Health Information Technician (RHIT) - AAPC American Academy of Professional Coders Upon Hire required
• Or CRT-Coding Specialist (CCS) - AHIMA American Health Information Management Association Upon Hire required
• Or CRT-Professional Coder - AAPC American Academy of Professional Coders Upon Hire required

Nice To Haves

• Knowledge of CPT, HCPCS, CMS claim formats (1450 and HCFA 1500)
• knowledge of with Microsoft (Word, Excel, Visio, OneNote, etc.)

Responsibilities

• Meets with providers and coding employees regularly on billing, coding and reimbursement issues applicable to their specialty.
• Reviews monthly reporting from billing system with a focus on revenue cycle metrics, unbilled accounts, and adequate documentation.
• Acts as a liaison between the Coding department and Spectrum Health to enhance educational awareness of coding and documentation.
• Participates and initiates process and quality improvement activities.
• Reviews coding patterns/trends and provides ongoing consultation to providers regarding coding and documentation issues.
• Proactively identifies and communicates problems and opportunities; actively recommends and implements solutions or process improvements.
• Presents information to physicians, administrators and other institutional leadership.
• Acts as an expert resource for administrators and physicians in regulatory, coding, billing compliance and financial functions.
• Processing pended claims and provider appeals, which consists of reviewing medical records and using various coding resources to confirm correct coding.

Benefits

• Comprehensive benefits package to meet your financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance
• Traditional and Roth retirement options with service contribution and match savings

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level