Outpatient Analyst

University of Washington•Seattle, WA

4d•Remote

About The Position

Performs daily activities related to auditing, education and training of one or more content areas ERHI has coding oversight for. Respond to general coding questions (ICD, DRG, CPT and HCPCS), engage in the development and/or implementation of audit/monitoring plans, participate in the development and/or delivery of educational and outreach materials, report on unit activities, maintain unit records, monitor regulatory developments, and help develop Coding program policies and procedure. Function as part of a departmental team to accomplish department activities, and work cooperatively with other ERHI and UW Medicine staff to identify and resolve shared issues and concerns. Enterprise Records and Health Information (ERHI) is a Shared Service Department that supports all aspects of the patient medical record from governance, integrity, documentation timeliness, completion, clinical coding, billing, release, and tracking to management of access, retention, and destruction. ERHI provides advice and resources related to the lifecycle management of all UW Medicine records. ERHI is an integral part of the Enterprise Revenue Cycle and has a unique role in the organization that supports both clinical and operational activities.

Requirements

Bachelor’s degree in a Health Sciences discipline, Business Administration or related field, or equivalent combination of education and/or work experience
Coding knowledge and experience in facility and/or professional coding
Four years increasingly responsible related experience, including coding auditing, analysis, education and training.
Certified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC)
Extensive knowledge of DRG, ICD, CPT and/or HCPCS coding principles

Responsibilities

Serve as an organization resource and content expert for current documentation and coding guidelines.
Provide education and training on the results of internal audits and partner with Compliance on external audit education.
Provide expert coding content knowledge to UW Medicine staff and other key stakeholders.
In conjunction with the Director, develop and deliver role-specific training for ERHI Coding staff, develop and implement effective monitoring, auditing and risk assessment activities.
Monitor developments in related rules, regulations and coding changes; make recommendations to the Assistant Director, as needed, to maintain coding compliance/quality and mitigate risk.
Coordinate with and provide guidance to Compliance, Clinical Documentation Improvement, Utilization Management, Clinical Resource Management and Patient Financial Services on matters involving coding/billing compliance content related issues.
Perform coding audits, analyze results and create audit reports.
Review DRG and CPT claim denials for commercial payers.
Maintain written documentation of actions, activities or assessments (e.g., investigations, patient rights, audits, process improvement projects, corrective action plans, education and training plans) in accordance with state and federal law, and institutional policies.
Retains records in accordance with the UW Retention Schedule and department policy.
Evaluate billing/coding/documentation behavior and identify recommendations for improvement.
Provide consultation and best practice guidance to engage and influence outcomes.
Review, analyze and determine effectiveness of training, assess effectiveness against entity/workforce member type/and industry KPI's (key performance indicators), and recommend enhancements to training content and user experience.
Manage or conduct audits, and ensure they are performed in accordance with the UW Medicine Audit Policy.
As a member of the Coding Analyst team, may perform any work that is necessary to complete department activities and meet established deadlines.