Coding Quality Analyst

The Ohio State University

4d•Remote

About The Position

The Outpatient Coding Quality Analyst evaluates the accuracy, completeness, and compliance of outpatient coding within Medical Information Management. The analyst conducts random, focused, and risk-based audits of coded medical records, including records processed through automated coding systems, and reviews ICD-10-CM diagnoses and CPT/HCPCS procedure code assignments. The role supports coding quality improvement, regulatory compliance, and claim and coding edit resolution. The analyst uses encoding and abstracting systems, the electronic health record, approved coding resources, spreadsheets, and automated reporting tools to validate code assignments and document audit findings and trends. The role also resolves claim and coding edits using approved references and follows established procedures when updating IHIS accounts or modifying codes and charges. The analyst provides coding specialists with timely feedback and guidance, collaborates with coding leadership and education staff to address identified opportunities, and performs follow-up reviews to assess corrective actions. The analyst maintains knowledge of coding guidelines and regulatory and payer requirements and recommends improvements to promote consistent practices and reduce denials and compliance risks. The position is eligible for a remote work schedule.

Requirements

Complete a CAHIIM-approved coding certificate program or HIMT program.
Demonstrate coding proficiency by satisfactorily completing OSUWMC’s coding test.
Have familiarity or experience with computer-assisted coding and/or an automated encoder.
Have a bachelor’s degree or equivalent experience.
Have at least 2 years of relevant experience.
For hospital coding, hold one of the specified credentials: RHIT, RHIA, CCS, COC, or CPC.
Maintain continuing education requirements determined by AHIMA or AAPC.

Nice To Haves

2–4 years of outpatient coding experience, preferably with ICD-10-CM and CPT for emergency, outpatient, ambulatory surgery, observation, and series/clinics services.
2–4 years of relevant experience.
Experience with computer-assisted coding and/or an automated encoder.

Responsibilities

Conduct random, focused, and risk-based audits of outpatient coded medical records, including records processed through automated coding systems.
Evaluate the accuracy, completeness, and appropriateness of ICD-10-CM diagnosis and CPT/HCPCS procedure code assignments.
Review and resolve claim and coding edits, including edits associated with CMS National Correct Coding Initiative (NCCI) and Outpatient Code Editor (OCE) requirements.
Respond to Central Business Office requests regarding coding and supporting documentation.
Use encoding and abstracting systems, the electronic health record, and approved coding references to validate code assignments.
Document audit activities, findings, and trends using designated systems, spreadsheets, and automated reporting tools.
Identify coding discrepancies, documentation concerns, trends, educational needs, and opportunities for improvement that may contribute to denials or compliance risks.
Provide coding specialists with timely feedback and guidance on coding guidelines and compliant practices.
Collaborate with coding leadership and education staff to communicate audit findings and address identified opportunities.
Conduct follow-up reviews to assess the effectiveness of education and corrective actions.
Follow established procedures when updating IHIS accounts or modifying codes and charges, ensuring changes are supported by documentation and accurately recorded.
Maintain knowledge of current coding guidelines and applicable regulatory and payer requirements.
Recommend improvements to strengthen coding accuracy, promote consistent coding practices, and support quality improvement and compliance.
Attend coding meetings and coding education sessions and review coding resources as needed to maintain education and follow official coding guidelines.