Coding Quality Analyst

Scope of Position
After medical records are coded in Medical Information Management (MIM), the Coding Quality Analyst is responsible for ensuring accuracy of coding +via random or focused auditing of medical records. In addition, the analyst is responsible for completing claim/coding edits and responding to requests from the Central Business Office (CBO) regarding documentation required for compliance with CMS National Correct Coding Initiative (NCCI) and Outpatient Code Editor (OCE) edits. The analyst is responsible for providing feedback to the Director of Outpatient Coding and Compliance regarding recommendations for improving coding accuracy and compliance.

Position Summary

Position eligible for flexible hybrid remote work schedule. The position is responsible for coding quality improvement and claim/coding edit resolution. This staff member reviews randomly selected and focused medical records for accurate selection of appropriate admitting and discharge diagnoses ICD-9-CM/ICD-10-CM, ICD-9-CM/CPT4 procedures. The analyst uses the encoding and abstracting system and other resources to ensure complete and accurate coding for hospital reimbursement, research and planning. The analyst uses responses such as system, spreadsheets, and automation to report all audit activities.
The approved claim/coding resolution reference material that includes, at minimum the NCCI database, Craneware, and charge description master file updates (provided by OSUWMC revenue cycle management team) to resolve claim/coding edits. The analyst follows standard operating procedures in regards to updating IHIS accounts and accurately modifying analyst advises medical record coding specialist on coding guidelines and compliant practices, as requested.

Minimum Qualifications Required: Associate degree in Health Information Management, and a minimum of 3-5 years medical center outpatient coding experience (ICD10CM and CPT) for service types such as emergency, outpatient, ambulatory surgery, observation, and series/clinics. Bachelor's degree in Health Information Administration or equivalent degree preferred.

Considerable progressively responsible administrative medical information management experience required knowledge and experience with electronic health records and health information management applications required.
Certifications can include: Registered Health Information Record Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS) by the American Health Information Management Association, COC (outpatient credential only).

Ongoing:
Maintain continuing education credits as required by the American Health Information Management Association. Attend coding and department meetings as well as timely completion of hospital CBLs.

Certification
RHIA, RHIT, CCS, or COC (outpatient credential only)