Coding Quality Education Review Specialist

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

📋 Description

• The Coding Quality and Education Review Specialist will assess accounts for precise and suitable coding and/or clinical documentation integrity (CDI) in line with the Company’s policies and procedures. This role involves participating in the identification of educational needs for the organization through the review process.

• Conduct assigned coding quality evaluations for all coding professionals (e.g., Lifepoint employed coders and contract coders) in compliance with The American Health Information Management Association (AHIMA) Standards of Ethical Coding, The Association of Clinical Documentation Improvement Specialist (ACDIS) Code of Ethics, Official Coding Guidelines, Lifepoint Health policies and procedures, The International Classification of Disease tenth revision (ICD-10) regulations, and the American Medical Association (AMA) Current Procedural Terminology (CPT) guidelines and reporting standards.

• Identify patterns and suggest relevant educational initiatives for coding professionals based on the outcomes of the coding quality evaluations.

• Compile audit summary reports for distribution to facility CFOs and compliance departments.

• Oversee the coding quality review schedules and the advancement of reviews; propose adjustments as needed to enhance the effectiveness and efficiency of the audit schedule.

• Act as a coding resource for assigned coding inquiries.

• Utilize independent judgment and decision-making skills while effectively working autonomously.

• Participate in educational webinars, conference calls, and other coding seminars, and engage in both formal and informal discussions about coding. Complete all assigned compliance training within the designated timeframe.

• Maintain a minimum of twenty (20) continuing education hours annually and uphold required credentials.

• Adhere to AHIMA’s Code of Ethics and Standards of Ethical Coding, Lifepoint Attendance Policy, and ensure patient/employee confidentiality and dignity by maintaining privacy without any infractions.

• Undertake other related job tasks or responsibilities as assigned.

⛳️ Requirements

• Education: An Associate’s degree in a healthcare-related field or an equivalent combination of education, experience, and training that equips the candidate with the necessary knowledge, skills, and abilities; a Bachelor’s degree is preferred.

• Experience: At least five years of experience, preferably in coding quality reviews and/or coding audits, with a minimum of three years of specific experience in Inpatient hospital coding.

• Familiarity with Diagnosis Related Groups (DRGs), Ambulatory Payment Categories (APCs), the Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative guidelines, Local and National Coverage Decisions, and other medical necessity/compliance guidelines for billing and coding is required.

• Experience working with a CDI team, writing queries, and interacting with multiple EMRs is essential.

• Certifications: Must possess one of the following certifications: Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), or another comparable nationally recognized acute care coding credential from AHIMA or AAPC.

🏝️ Benefits

• Comprehensive Benefits: A variety of medical, dental, and vision plans—customized benefit options for part-time and PRN employees, among others.

• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave, and paid time off.

• Financial & Career Growth: Assistance with higher education and certification tuition, loan support, and a 401(k) retirement package with company matching.

• Employee Well-being: Programs focused on mental, physical, and financial wellness (including free gym memberships, virtual care appointments, mental health services, and discount programs).

• Professional Development: Continuous learning and career advancement opportunities.