QI Coding Compliance Specialist

Baptist Health•Little Rock, AR

About The Position

The QI Coding Compliance Specialist reviews clinical documentation and applies appropriate billing and diagnostic codes according to acceptable guidelines. The specialist develops and implements mechanisms for tracking coding trends and patterns and consults with the Medical Director and Regional Practice Administrators on regulatory compliance issues related to coding. The Certified Coder provides physician consultation, auditing, training, planning, and other coding services across a broad range of specialties, including Family Practice, Internal Medicine, Pediatrics, OB/GYN, Surgery, GI, Emergency Medicine, Sleep, Neurology, Neurosurgery, Anesthesia, Ophthalmology, Oncology, ENT, Epilepsy, and Orthopedics. The role also includes physician coding reviews and audits, development of training tools, training staff on coding regulation changes, consulting with clinics and managers on coding questions, and helping create templates, fee tickets, and other forms. The specialist participates in coding workshops, in-services, and seminars, and performs other duties as requested. A high degree of verbal and written communication and professionalism is required. The desired candidate works well with the existing QI team under the direction of the Medical Director.

Requirements

Extensive knowledge of medical terminology.
In-depth understanding of ICD-10-CM and CPT coding principles, with a focus on evaluation and management services.
Fundamental knowledge of current standard billing practices as defined by the AMA.
Ability to interpret clinical data.
Knowledge of Continuous Quality Improvement principles in a healthcare setting.
Outstanding written and oral communication skills.
Computer skills.
High degree of professionalism.

Nice To Haves

Bachelor's degree preferred.
Clinical background is a plus.
Formal education in medical records procedures is ideal.

Responsibilities

Review clinical documentation and apply appropriate billing and diagnostic codes using acceptable guidelines.
Develop and implement tracking mechanisms for coding trends and patterns.
Consult with the Medical Director and Regional Practice Administrators about regulatory compliance issues related to coding.
Provide physician consultation, auditing, training, planning, and other coding services across multiple specialties.
Conduct physician coding reviews and audits.
Develop training tools and train staff members on coding regulation changes.
Serve as a coding consultant to clinics and managers.
Assist with creating templates, fee tickets, and other forms as necessary.
Participate in coding workshops, in-services, and seminars.
Perform other duties as requested.