Senior Coding Data Quality Analyst - Provider Based
Lehigh Valley Health Network•REMOTE IN PENNSYLVANIA, PA
•Remote
About The Position
Develops, implements, and maintains a coding and reimbursement quality management plan at the network level. Utilizes output for financial and billing purposes to meet licensure requirements, network quality initiatives, statistics, and for public hospital and physician reporting.
Requirements
- Associate’s Degree in health information management program or work experience in a complex coding environment, equivalent to Associates Degree.
- 4 years of experience coding/abstracting of complex provider-based patient encounters.
- Expert knowledge of ICD-10CM, HCPCS/CPT coding, modifiers, and reimbursement methodologies (wRVUs).
- Microsoft Office and presentation skills.
- CCA - Certified Coding Associate AHIMA - State of Pennsylvania Upon Hire or CCS - Certified Coding Specialist AHIMA - State of Pennsylvania or CCS-P - Certified Coding Specialist-Physician Based AHIMA - State of Pennsylvania or CPC - Certified Professional Coder - State of Pennsylvania or CPC-H-Certified Professional Coder-Hospital AAPC - State of Pennsylvania
Nice To Haves
- Bachelor’s Degree in health information management program.
- 1 year of experience auditing of provider-based coding and 1 year of experience in provider-based coder training.
- Auditing and training.
- Knowledge of medical terminology, anatomy and physiology, pathophysiology, regulatory agency requirements, severity of illness classification, and health care statistics computation.
Responsibilities
- Conducts formal education and training for staff on policies/procedures, coding guidelines, regulatory requirements, and work processes.
- Provides feedback and develops educational action plans.
- Performs code monitoring and auditing activities providing individual, departmental, and topic related results according to established schedule.
- Researches and responds to coding questions from staff.
- Evaluates the quality of clinical documentation to spot incomplete or inconsistent documentation impacting code selection.
- Anticipates documentation issues in response to upcoming regulatory updates.
- Maintains database for internal reporting of quality outcomes.
- Establishes, implements, and maintains a formalized review process to support coding compliance.
Benefits
- Great Place to Work® certification
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Associate degree
