Hartford HealthCare · 6 hours ago
Coding Quality & Edu Spec 1 / HIM Coding
Newington, CT
Full-time
Onsite
Mid, Senior Level
4+ years expHartford HealthCare is Connecticut’s most comprehensive healthcare network, seeking a Coding Quality & Edu Spec 1 to ensure accuracy and compliance in medical coding. The role involves auditing coding practices, providing education and training, and managing communication of coding regulations and policies.
Health CareHealth DiagnosticsHospitalOncologyPharmaceuticalRehabilitation
Responsibilities
Validates International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) diagnoses and ICD-10-PCS (Procedural Classification System) or Current Procedural Terminology(CPT) codes and resulting DRGs/APCs to ensure consistency and efficiency in claims processing, data collection, and quality reporting for HHC
Validates Home Health Coding/OASIS reviews
Prepares written reports on the results of the audits, including recommendations for improvement and compliance with state and federal laws, regulations and policy
Presents audit reports, results and action plans to coding management for discussion and plan for dissemination to coders
Presents quarterly Key Performance Indicators (KPI) to compliance office
Responsible for managing CHIME (Connecticut Health Information and Management Exchange) and Premier system edits
Utilize Cobius Institutional Audit Manager (IAM) software to streamline audits, communicate findings, and simplify reports
Provides feedback and creates focused educational/training programs on the results of auditing and monitoring activities for coders, CDS and providers as appropriate
Provides Coder, CDS staff and provider education on changes in regulations related to coding
Provides coding feedback on complex cases
Insures the appropriate dissemination and communication of all regulation, policy, and guideline changes (eg. Code updates, coding guidelines, Local Coverage Determinations (LCD), Transmittals) to affected personnel
Maintains system folders with coding policies, procedures, educational articles and coding compliance materials
Participates in the development and review of HIM Coding Policy and Procedures
Participates in general or special assignments and other duties as assigned
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines
Qualification
Required
Associates Degree or equivalent experience
Four or more years of progressive on-the-job coding experience in an acute care hospital
CCS or CPC certification
Home Health Coding Specialist – Diagnosis (HCS-D) and/or Home Care Coding Specialist – Hospice (HCS-H)
Home Health Clinical Specialist - OASIS (HCS-O) or OASIS Specialist – Certified (COS-C)
Strong written and verbal communication skills
Solid analytical capabilities
Good organizational skills
Critical thinking, problem solving and deductive reasoning skills
Comprehensive understanding of ICD-10-CM diagnosis and ICD-10-PCS and/or CPT/HCPCS operative procedure codes
Understands the Uniform Hospital Discharge Data Set (UHDDS)
Understands MS-DRGs, APCs and/or Outpatient Code Edits (OCE) and Correct Coding Initiative (CCI) edits
IRF-PAI (IP Rehabilitation)
Home Health understands: PDGM payment model, OASIS
Working knowledge of clinical information
Extensive knowledge of state, federal and Medicare regulations related to coding
Basic knowledge of the revenue cycle for the purpose of communicating corrective action recommendations
Microsoft Office Products; Word, Excel
Encoder and/or Computer Assistant Coding (CAC)
HROI and Cobius
Function independently
Handle multiple priorities
Listen and acknowledge ideas and expressions of others attentively
Converses clearly using appropriate verbal and body language
Collaborate with others to achieve a common goal through mutual cooperation
Influence others for positive and productive outcomes
Benefits
Competitive benefits program designed to ensure work/life balance
Company
Hartford HealthCare
Hartford HealthCare is a group of hospitals that offers complete healthcare services including cancer care, rehabilitation and pharmacy.
10001+ employees
H1B Sponsorship
Hartford HealthCare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (7)
2024 (2)
2023 (4)
2022 (6)
2021 (4)
2020 (8)
Funding
Current Stage
Late StageTotal Funding
$150MKey Investors
Connecticut Health and Educational Facilities Authority
2024-04-01Debt Financing· $150M
Leadership Team
Jeffrey Flaks
President & Chief Executive Officer
Bimal Patel
President and COO
Recent News
Hartford Business Journal
2025-12-18
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