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Inside Higher Ed · 2 weeks ago

Coding Quality Analyst

United States

Full-time

Remote

Mid Level

3+ years exp

Inside Higher Ed is associated with The Ohio State University, which is seeking a Coding Quality Analyst. The role primarily focuses on ensuring the accuracy of medical coding through auditing and providing quality improvement feedback, while also managing compliance-related documentation.

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Responsibilities

Ensuring accuracy of coding assignment via random auditing of medical record coding and accuracy of MS-DRGS

Completing 3M APC Software claim edits

Responding to requests from the Central Business Office (CBO) regarding documentation required for compliance with CMS’ National Correct Coding Initiative (NCCI) and Outpatient Code Editor (OCE) edits

Providing feedback to the Manager of Data Quality regarding coding quality

Making recommendations for improving coding accuracy

Reviewing randomly selected and focused medical records for accurate selection of appropriate admitting and discharge diagnoses, ICD9-CM procedures and CPT4 procedures

Using the encoding and abstracting system and other resources to ensure complete and accurate coding, DRG/MS-DRG assignment for hospital reimbursement, research and planning

Keeping detailed records of all audits conducted, the results, recommendations, and following up to assure action is taken

Advising medical record coding specialist on coding guidelines and practices as requested

Qualification

ICD10-CM codingCPT codingHealth Information Management3M APC SoftwareElectronic health recordsRHIT certificationRHIA certificationCCS certificationAttention to detailCommunication skills

Required

Associate degree in Health Information Management

Minimum of 3-5 years medical center outpatient coding experience (ICD10-CM and CPT) for service types such as emergency, outpatient, ambulatory surgery, observation, and series/clinics

Considerable progressively responsible administrative medical information management experience

Required knowledge and experience with electronic health records and health information management applications

Certifications can include: Registered Health Information Record Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS) by the American Health Information Management Association, COC (outpatient credential only)