CHRISTUS Health
Job Summary
The Coding Quality Specialist reports to the HIM Coding Education Manager to perform internal departmental coding reviews in support of the Coding Operations Department’s business needs. This position contributes to coding education and training and facilitates pre-bill and cross-training in order to advance and keep current, the skillset of our HB coding associates. The Coding Quality Specialist demonstrates high caliber specialty knowledge and understanding of current ICD-10-CM, ICD-10-PCS and/or CPT/HCPCS coding guidelines and practices in both inpatient and outpatient care settings, maintaining a 95% accuracy rate. Assignments are based on departmental needs and include but are not limited to PEPPER reviews, new-hire and standard pre-bill reviews, remediation and performance improvement reviews and those required for corrective action plans, query quality and other focused reviews as may be needed.
Responsibilities
Meet expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Facilitate and complete inpatient and outpatient coding reviews.
Communicate findings both verbally and in writing in an approved, appropriate format to support training and education such as would be reported in Coding Roundtables or Section Meetings.
Assist with development and coordination of review plans, feedback to coding staff and management to include query opportunities, documentation opportunities, accurate code assignment (ICD, CPT, HCPCS), accurate payment groupings (DRG, APC), accurate modifier assignment, accurate POA assignment, accurate discharge disposition assignment, compliance and data management.
Assist with chart sample selection for reviews and randomization to be coordinated with Coding Managers.
Assist with finalizing an annual work plan for targeted chart reviews and pre-bill reviews.
Work collaboratively with Coding Integrity Department to recommend and assist with content and examples that may be used to develop job aides, coding best practice references and other assisting resources to support and advance coder knowledge and expertise. Review results and perform trend analyses to identify patterns and variations in coding practices and/or case‑mix index which require education.
Meet or exceed an accuracy rate of 95%.
Ensure coding reviews are appropriate and effective. Assess effectiveness through associate evaluations.
Have strong written and verbal communication skills.
Be able to work independently in a remote setting, with minimal supervision.
Perform all other work duties as assigned by Manager.
Education & Skills
High school diploma or equivalent years of experience required.
Completion of accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred.
Experience
Five (5) or more years of inpatient and/or outpatient HB coding experience in an acute care setting preferred.
Licenses, Registrations, or Certifications
Registered Health Information Administrator (RHIA) (AHIMA) required.
Registered Health Information Technician (RHIT) (AHIMA) required.
Certified Coding Specialist (CCS) (AHIMA) required.
Work Schedule 5 Days - 8 Hours
Work Type Full Time
EEO Statement EEO is the law – https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf
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Responsibilities
Meet expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Facilitate and complete inpatient and outpatient coding reviews.
Communicate findings both verbally and in writing in an approved, appropriate format to support training and education such as would be reported in Coding Roundtables or Section Meetings.
Assist with development and coordination of review plans, feedback to coding staff and management to include query opportunities, documentation opportunities, accurate code assignment (ICD, CPT, HCPCS), accurate payment groupings (DRG, APC), accurate modifier assignment, accurate POA assignment, accurate discharge disposition assignment, compliance and data management.
Assist with chart sample selection for reviews and randomization to be coordinated with Coding Managers.
Assist with finalizing an annual work plan for targeted chart reviews and pre-bill reviews.
Work collaboratively with Coding Integrity Department to recommend and assist with content and examples that may be used to develop job aides, coding best practice references and other assisting resources to support and advance coder knowledge and expertise. Review results and perform trend analyses to identify patterns and variations in coding practices and/or case‑mix index which require education.
Meet or exceed an accuracy rate of 95%.
Ensure coding reviews are appropriate and effective. Assess effectiveness through associate evaluations.
Have strong written and verbal communication skills.
Be able to work independently in a remote setting, with minimal supervision.
Perform all other work duties as assigned by Manager.
Education & Skills
High school diploma or equivalent years of experience required.
Completion of accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred.
Experience
Five (5) or more years of inpatient and/or outpatient HB coding experience in an acute care setting preferred.
Licenses, Registrations, or Certifications
Registered Health Information Administrator (RHIA) (AHIMA) required.
Registered Health Information Technician (RHIT) (AHIMA) required.
Certified Coding Specialist (CCS) (AHIMA) required.
Work Schedule 5 Days - 8 Hours
Work Type Full Time
EEO Statement EEO is the law – https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf
#J-18808-Ljbffr