Coding Education, Quality Analyst

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Perform comprehensive coding audits on clinical coding records spanning inpatient, outpatient, observation, emergency department, and OhioHealth Physician Group clinic service lines.

• Execute facility and charge-entry audits for hospital, Neighborhood Care, vascular interventional radiology, rehabilitation, and clinic coding records.

• Collaborate with Clinical Documentation Improvement staff and Data Quality Engineers to guarantee precise capture and reporting of Hospital and Physician Quality Indicators.

• Track and monitor PQRI reports for practitioners and Operations staff.

• Investigate federal regulations, coding guidelines, and reference materials.

• Relay coding and compliance updates to physicians, management, coding personnel, and failed claims staff.

• Aid in resolving unbilled and billed claim rejections associated with coding and documentation.

• Ensure that encounter forms are current and compliant.

• Provide education to physicians, coders, failed claims specialists, clinical documentation specialists, and various departments on coding, billing, documentation, and compliance.

• Deliver ICD-10-CM/PCS education throughout the OhioHealth System.

• Engage with medical staff concerning coding inquiries for Central Ohio hospitals.

• Assist in the formulation of cross-departmental policies and procedures.

• Prepare and submit responses to third-party audits, including those conducted by insurance companies.

• Assess new hires and coders subject to quality monitoring and share findings with coding management.

⛳️ Requirements

• A high school diploma or GED is mandatory.

• A minimum of 3 years of coding experience is required.

• Certification as a CCS (Certified Coding Specialist), CCSP (Cisco Certified Security Professional), CPC (Certified Professional Coder), CPCH (Certified Professional Coder—Hospital), or RHIA (Registered Health Information Administrator) is essential.

• Familiarity with ICD-10-CM/PCS, coding, billing, clinical documentation, and coding compliance is necessary.

• Understanding of federal regulations, coding rules, and payer requirements is important.

• Capability to conduct coding and documentation audits across various service lines including inpatient, outpatient, observation, emergency department, vascular interventional radiology, rehabilitation, hospital, and clinic.

• Proficiency in educating physicians, coders, failed claims specialists, and clinical documentation specialists.

• Ability to prepare and submit responses to third-party audits is required.

• Skill in evaluating coding quality and productivity is necessary.

• Competence in collaborating with medical staff and coding management is essential.

🏝️ Benefits

• Full-time schedule of 40 hours per week.

• Day shift.

• Remote work from Ohio.