Coding Education & Quality Analyst

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Job Description Summary:

This position conducts professional coding audits of clinical coding records across inpatient, outpatient, observation, emergency department, and all OhioHealth Physician Group (OPG) clinic service lines. The Education and Quality Analyst provides education to physicians, coders, failed claims specialists, and clinical documentation specialists regarding coding, billing, clinical documentation, and coding compliance. The analyst also collaborates with medical staff to address coding queries across all OPG clinic service lines. In addition, the Coding Education and Quality Analyst helps ensure that coding and billing for patient services comply with governmental program requirements and the contractual obligations of non-governmental payers. This position is also responsible for preparing and submitting responses to third-party audits, including those conducted by insurance companies. The analyst evaluates the quality and productivity of new hires and coders who are subject to quality monitoring. Quality-monitoring results are shared with coding management to support performance improvement efforts and, when appropriate, the development of work improvement plans.

Responsibilities And Duties:

40%
Documentation Audit This position conducts facility and charge entry audits of all Hospital, Neighborhood Care, Vascular Interventional Radiology, Rehab and clinic coding records. This includes inpatient, outpatient, observation, emergency department, vascular interventional radiology diagnostic and clinic service lines. Works with Clinical Documentation Improvement staff and Data Quality Engineers to ensure accurate capture and reporting of Hospital and Physician Quality Indicators for external reporting purposes. Monitors and tracks PQRI reports as applicable to individual practitioners and Operations staff. Reviews MediRegs, research of federal regulations, coding rules and regulations, and other reference material. Communicates coding and compliance updates to appropriate staff including physicians and management as appropriate. Assists Coding Management and Failed Claims with resolution of unbilled and billed claim rejections related to coding and documentation as well as other facility departments regarding coding and charge issues as applicable. Ensures encounter forms are updated and compliant.
35%
Education The Education and Quality Analyst educates physicians, coders, failed claims specialists and clinical documentation specialists on coding, vascular interventional radiology, billing, clinical documentation and coding compliance. Communicates coding and compliance updates to all coding staff and failed claims. Also educates other departments and individuals as necessary regarding coding rules, documentation guidelines and charge issues. Will be primarily responsible for ICD-10 CM/PCS education for entire OhioHealth System.
15%
Physician Queries Responsible for interacting with medical staff for all coding queries for all Central Ohio Hospitals.
10%
Policy and Procedural Development/Other Duties Assists in development of policies and procedures crossing multiple department lines. All other duties as assigned.

Minimum Qualifications:

High School or GED (Required)CCS - Certified Coding Specialist - American Health Information Management Association, CCSP - Cisco Certified Security Professional - CISCO - Computer Information System Company, CPC - CPC Certified Professional Coder - AAPC American Academy of Professional Coders, CPCH - Certified Professional Coder - Hospital - AAPC American Academy of Professional Coders, RHIA - Registered Health Information Administrator - American Health Information Management Association

Additional Job Description:

CCS - CCS CCSP - CCSP CPC - Certified Professional Coder CPCH - Certified Professional Coder - Field of Study: Coding Years of Experience 3

Work Shift:

Day

Scheduled Weekly Hours :

40

Department

Physician Coding

Join us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in the healthcare industry

Equal Employment Opportunity

OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment 

Remote Work Disclaimer:

Positions marked as remote are only eligible for work from Ohio.