Senior Coding Data Quality Analyst

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

📋 Description

• Develops, executes, and upholds a quality management plan for coding and reimbursement at the network level.

• Provides training and education for both coding and clinical personnel.

• Acts as a coding resource for the organization.

• Conducts coding, monitoring, and auditing activities, delivering individual, departmental, and topic-specific results according to a set schedule.

• Facilitates formal training sessions for staff on policies, procedures, coding standards, regulatory requirements, and operational processes.

• Offers feedback and creates educational action plans.

• Establishes, implements, and maintains a structured review process to ensure coding compliance.

• Assists the manager in ensuring that new employees receive adequate training as well as ongoing training for current staff.

• Investigates and addresses inquiries from the coding team.

• Assesses the quality of clinical documentation to identify any incomplete or inconsistent documentation that may affect code selection.

⛳️ Requirements

• High School Diploma or GED.

• Four years of experience in coding and abstracting complex patient encounters.

• Proficiency in Microsoft Office and presentation skills.

• Knowledge of medical terminology, anatomy and physiology, pathophysiology, regulatory agency standards, severity of illness classification, and healthcare statistics computation.

• Familiarity with ICD-10-CM/PCS, HCPCS/CPT, modifiers, charge applications, and reimbursement methodologies (DRG, APC).

• CCA - Certified Coding Associate AHIMA - State of Pennsylvania upon hire, or CCS - Certified Coding Specialist AHIMA - State of Pennsylvania, or CCS-P - Certified Coding Specialist-Physician Based AHIMA - State of Pennsylvania, or CPC - Certified Professional Coder - State of Pennsylvania, or CPC-H - Certified Professional Coder-Hospital AAPC - State of Pennsylvania.

🏝️ Benefits

• Health insurance

• 401(k) matching

• Paid time off

• Professional development programs