Coding Quality Analyst Priority Health
About The Position
The Coding Quality Analyst acts as a liaison among physician practices, rehab services, the professional billing office, coding, payer relations, compliance, revenue management operations of patient financial services, and Spectrum Health. The role supports management and employees and conducts coding quality reviews for the coding department, rehab services, and physician practices. The analyst meets regularly with providers and coding employees to address billing, coding, and reimbursement issues relevant to their specialties. The role also reviews billing-system reports, monitors coding patterns and trends, advises on documentation and coding, contributes to education and quality improvement, and serves as an expert resource on regulatory, compliance, and financial matters.
Requirements
- Bachelor's degree in accounting, finance, health care administration, or a related field, or an equivalent combination of education and experience.
- At least 2 years of progressive, relevant experience in various hospital functions, such as professional or facility coding, reimbursement, billing, and/or chargemaster maintenance.
- One of the following credentials: Registered Health Information Administrator (RHIA) from AHIMA; Registered Health Information Technician (RHIT) from AAPC; Coding Specialist (CCS) from AHIMA; or Professional Coder from AAPC.
Responsibilities
- Meet regularly with providers and coding employees regarding billing, coding, and reimbursement issues applicable to their specialties.
- Review monthly billing-system reports, focusing on revenue-cycle metrics, unbilled accounts, and adequate documentation.
- Act as a liaison between the Coding department and Spectrum Health to enhance education and awareness of coding and documentation.
- Participate in and initiate process and quality improvement activities.
- Review coding patterns and trends and provide ongoing consultation to providers on coding and documentation issues.
- Identify and communicate problems and opportunities, and recommend and implement solutions or process improvements.
- Present information to physicians, administrators, and other institutional leadership.
- Serve as an expert resource for administrators and physicians on regulatory, coding, billing compliance, and financial functions.
Benefits
- Comprehensive benefits package supporting financial, health, and work/life balance goals.
- On-demand pay program powered by Payactiv.
- Discounts on restaurants, phone plans, spas, and other purchases.
- Optional identity theft protection, home insurance, and auto insurance.
- Traditional and Roth retirement options with service contribution and matching savings.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
