Quality Analyst

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

📋 Description

• Assess the precision, thoroughness, and adherence to standards of outpatient coding through random, focused, and risk-based audits.

• Examine coded medical records, including those processed via automated coding systems.

• Address claim and coding edits while responding to inquiries from the Central Business Office.

• Implement CMS NCCI and OCE guidelines, Craneware, payer instructions, and updates to the charge description master.

• Detect discrepancies in coding, documentation issues, denial patterns, and compliance risks.

• Record and report audit activities, findings, and trends using designated systems, spreadsheets, and automated reporting tools.

• Offer prompt feedback and direction to coding specialists.

• Work in collaboration with coding leadership and education teams to tackle opportunities and educational needs.

• Perform follow-up reviews to evaluate the effectiveness of corrective actions and educational initiatives.

• Stay updated on coding guidelines and regulatory as well as payer requirements.

• Update IHIS accounts and adjust codes or charges in accordance with standard operating procedures and supporting documentation.

• Suggest enhancements to coding accuracy, consistency, reimbursement, and compliance.

⛳️ Requirements

• Completion of a CAHIIM-approved coding certificate program or HIMT program is required.

• Successful completion of OSUWMC’s coding assessment.

• Familiarity or experience with computer-assisted coding and/or automated encoders is preferred.

• A Bachelor's degree or equivalent experience is necessary.

• A minimum of 2 years of relevant experience is required.

• 2–4 years of outpatient coding experience is preferred, including proficiency in ICD-10-CM and CPT for emergency, outpatient, ambulatory surgery, observation, and series/clinics.

• For hospital coding: must hold credentials such as RHIT, RHIA, CCS, COC, or CPC.

• Must meet ongoing education requirements as mandated by AHIMA or AAPC.

• Final candidates must successfully complete a background check; a drug screen or physical may be required post-offer.

🏝️ Benefits

• Eligibility for a remote work schedule.

• Regular employment position.

• 40 scheduled hours each week.

• First shift hours.

• Opportunities for continuing education and coding education sessions.