Coding Quality Analyst - Inpatient
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Upload Your ResumeAbout This Role
This role is responsible for ensuring regulatory compliance and coding accuracy through audits and monitoring changes to laws and regulations. The analyst will lead client-facing meetings and provide expert knowledge in coding operations and best practices.
Responsibilities
- Maintain and demonstrate expert knowledge of coding, coding operations, and best demonstrated coding practices
- Serve as the expert of applicable Federal, State, and local laws and regulations to ensure adherence
- Communicate the potential impact of compliance issues and risks to applicable stakeholders
- Collaborate with applicable regulators (e.g., CMS) to prevent or address potential compliance issues
- Conduct internal monitoring/auditing to identify process gaps and address organizational risks
- Analyze results of audits and monitoring processes to identify potential risks and communicate as needed
- Identify and analyze applicable patterns/trends to identify potential compliance issues
- Develop and/or deliver training on compliance issues and risks to applicable audiences
- Consult with internal and external stakeholders to advocate and drive effectiveness of compliance programs
- Provide quality performance feedback by completing internal coding quality audits
Requirements
- High School Diploma/GED
- AAPC or AHIMA (CCS, CPC, RHIT or RHIA) certification
- 5+ years of Inpatient Facility coding and auditing experience
- 1+ years of experience working collaboratively with CDI and quality leadership in partnership to improve reimbursement and coding accuracy
- 1+ years of experience with computer assisted coding technologies and EMR (Electronic Medical Record) coding workflow
- Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint, and SharePoint
Qualifications
- High School Diploma/GED
- 5+ years of Inpatient Facility coding and auditing experience
Nice to Have
- Outpatient coding experience in a coder or reviewer role
- Operational knowledge of health care related to Federal and State regulations, as well as standards from regulatory agencies and accrediting organizations (e.g., CMS, TJC)
- Proven excellent organizational skills
- Demonstrated ability to work with a variety of individuals in executive, managerial and staff level positions
Skills
* Required skills
Benefits
Certifications
About Optum
Kelsey-Seybold Clinic, part of the Optum family of businesses, is one of the nation's leading health care organizations, providing coordinated and accountable care across 40+ locations in Houston.