HIM CODING QUALITY ANALYST - Health Information - Full Time - Days

HIM Coding Quality Analyst - Full Time

Shift: 7:00am - 3:30pm

Job Description:

PATIENT POPULATION:
The patient population served can be all patients, including geriatric, adult, adolescent, pediatric, and newborn. This also includes services which affect facility staff, physicians, visitors, vendors and the general public.

POSITION SUMMARY:
Under the supervision of the Director of Health Information Management (HIM), the HIM Coding Quality Analyst will perform coding quality auduits of inpatient and outpatient records to assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) quidelines and to provide ongoing feedback and analysis of the education needs for the coding staff.

Must be able to work normal/scheduled working hours to include Holidays, call-backs, weeknights, weekends, and on-call. Agrees to participate, as directed, in emergencies and community disasters during scheduled and unscheduled hours.

Needs to recognize that they have an affirmative duty and responsibility for reporting perceived misconduct, including actual or potential violations of laws, regulations, policies, procedures, or this organization’s standards/code of conduct.

The employee shall work well under pressure, meet multiple and sometimes competing deadlines; and the incumbent shall at all times demonstrate cooperative behavior with colleagues and supervisors.

EDUCATION/TRAINING/EXPERIENCE:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

To perform this job successfully, an individual should be a high school graduate or equivalent. Must have extensive knowledge of federal, state and payer-specific regulations and policies pertaining to documentation, coding and billing. Ability to analyze and identify opportunities in documentation improvement. Knowledge of medical terminology, anatomy and physiology, CPT, ICD (9 and 10), and HCPCS coding. Knowledge of Medicare and Medicaid (CMS) regulations. Must have a minimum of 6 years coding experience and 1 year coding auditing experience or equivalent.

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence if required. Ability to work with physicians in a collaborative manner.

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages if required.

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Effective time management skills to permit working in a fast-paced, results-oriented environment. Detail oriented.

To perform this job successfully, an individual should have demonstrated data entry skills. Type 40-50 wpm. Computer terminal experience and basic working knowledge of commonly used business software (including but not limited to Microsoft Office, Word, Excel and e-mail).

LICENSURE/CERTIFICATIONS:
Must have previous coding audit experience. Must hold one or more of the approved coding certification (i.e., Certified Coding Specialist (CCS), Certified Coding Specialist – Physician Based (CCS-P), Certified Professional Coder (CPC), or equivalent approved certification, with a minimum of 6 years of coding experience in an acute care facility using ICD-9-CM and CPT/DRG assignment.