Integrity Analyst – PB Coding Quality, Medical Specialties

This is a fully remote position, open to applicants in Alabama, +32 more states.

📋 Description

• Conduct research, interpret, and apply coding, payer, and regulatory standards to ensure precise and compliant professional and hospital coding.

• Create, maintain, and revise coding guidelines, standard operating procedures, reference materials, and position statements.

• Organize and assist in coding quality audits by managing requests, keeping records, and ensuring documentation is complete and accurate.

• Monitor audit findings, quality concerns, and compliance risks, documenting trends and aiding in corrective measures.

• Evaluate coding quality data and audit results to uncover trends, risks, and areas for improvement.

• Compile summaries, reports, and materials for leadership, audit reviews, and quality enhancement initiatives.

• Collaborate with Integrity Operations, coding leadership, clinicians, and education teams to enhance documentation quality and coding accuracy.

• Assist with regulatory, compliance, and quality-related projects in line with organizational policies and AHIMA coding standards.

• Address internal inquiries regarding coding guidance, quality findings, and audit results.

• Aid in testing, validation reporting, and workflow enhancements for coding quality, guidance, and compliance initiatives.

• Travel as necessary, with potential exposure to road and weather hazards.

⛳️ Requirements

• An Associate degree or equivalent education and experience is required.

• A coding certification from AHIMA or AAPC, such as RHIA, RHIT, CCS, CCS-P, or CPC, is mandatory.

• A second specialty credential is preferred, specifically CPMC and CMC.

• A minimum of 5 years of experience in advanced professional coding or hospital-based coding is required.

• Proficiency in revenue cycle processes, health information workflows, and medical record auditing is essential.

• Experience in medical specialty and/or surgical coding is necessary.

• E/M level coding experience is required.

• Advanced knowledge of ICD, CPT, and HCPCS coding guidelines is essential.

• In-depth understanding of medical terminology, anatomy, and physiology is required.

• Strong ability to identify coding quality issues and offer recommendations is necessary.

• Advanced skills in analyzing trends and data and presenting them statistically are required.

• Exceptional organization, communication, prioritization, reading comprehension, analytical, and training skills are necessary.

• Advanced proficiency in Microsoft Office, video and web conferencing, email, electronic coding, and EHR systems or applications is required.

• Extensive knowledge of care delivery documentation systems and medical record documents is necessary.

• Capability to work independently and exercise independent judgment is essential.

• Ability to meet deadlines in a fast-paced environment is required.

• Initiative and collaborative work skills are essential.

• Strong ethical standards are required.

• Experience with remote workforce operations is mandatory.

• Must be eligible to work remotely from one of the approved registered states: Alabama, Alaska, Arkansas, Arizona, Delaware, Florida, Georgia, Iowa, Idaho, Illinois, Indiana, Louisiana, Kansas, Kentucky, Maine, Michigan, Missouri, Mississippi, Montana, North Carolina, North Dakota, Nebraska, New Hampshire, New Mexico, Nevada, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, West Virginia, or Wyoming.

🏝️ Benefits

• Eligibility for benefits.

• Premium pay for shifts, on-call duties, and more, based on the teammate's role.

• Incentive pay for select positions.

• Opportunity for annual pay increases based on performance.

• Paid Time Off programs.

• Medical, dental, vision, life, and short- and long-term disability benefits.

• Flexible Spending Accounts for eligible healthcare and dependent care expenses.

• Adoption assistance and paid parental leave.

• Defined contribution retirement plans with employer matching.

• Additional financial wellness programs.

• Educational Assistance Program.

• Full-time remote work arrangement.

• First-shift schedule, Monday through Friday.