QA Coding Specialist - HIMS OP Coding

Kettering Health Network • Miamisburg, OH

6d • Onsite

About The Position

Under the supervision of the Coding Manager, the Quality Assurance Specialist is responsible for educating and training coding staff on the proper application of medical coding guidelines. This role ensures that coding staff accurately translate patient medical records into standardized codes (ICD-10-CM and CPT) for billing and reimbursement purposes. Additionally, the Quality Assurance Specialist conducts audits of medical record coding to ensure compliance with established guidelines and provides results to relevant stakeholders. This role also administers educational activities based on both internal and external audit findings to promote adherence to state/federal laws and regulatory requirements.

Requirements

• High school diploma or equivalent
• Minimum three years’ experience coding in acute care hospital required.
• RHIT, RHIA, or CCS required.
• Proficient in data entry using Microsoft Office Suite products.
• Skilled in Solventum CRS and CAC systems for coding and documentation.
• Experienced with Epic EMR, navigating electronic medical records with ease.
• Strong written and verbal communication skills, facilitating clear and concise information exchange.
• Thorough application of medical terminology successfully translated into codeable language.
• Solid understanding of anatomy and physiology, with expertise in associating disease processes with corresponding codes.
• In-depth knowledge of regulatory and governing body coding and billing guidelines.

Nice To Haves

• Preferred associate degree in healthcare related field.
• Two years of supervisory / leadership experience preferred.
• Preferred member of AHIMA and/or AAPC Professional Associations.

Responsibilities

• Educating and training coding staff on the proper application of medical coding guidelines.
• Ensuring coding staff accurately translate patient medical records into standardized codes (ICD-10-CM and CPT) for billing and reimbursement purposes.
• Conducting audits of medical record coding to ensure compliance with established guidelines and provides results to relevant stakeholders.
• Administering educational activities based on both internal and external audit findings to promote adherence to state/federal laws and regulatory requirements.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees