CODING QUALITY REVIEWER-HOSPITAL

Job Description

• POSITION SUMMARY
  
  • Responsible for coding quality audits for all facility coded records, including inpatient, same day surgery, outpatient, clinic facility, emergency trauma center and therapy services. The position will assure appropriateness and accurate DRG, diagnosis, procedure and CPT code assignments in accordance with coding and federal guidelines in accordance with the department coding compliance plan. Provides on-going education and feedback based on review results to coding professionals and contract coding staff. Monitors denials for trends and provides education to coding team. Aids with coding questions from coders as well as providers, CDI and other staff as needed. This position works closely with the Coding Manager - Facility to assure staff are updated on new coding guidelines and changes to the code sets. Assist the manager with other duties as assigned.
    
• MINIMUM QUALIFICATIONS AND REQUIREMENTS
  
  • Licenses and Certifications Required
    
    • Certified Coding Specialist (CCS) required.
      
  • Educational Requirements
    
    • Bachelor’s or Associate’s degree required. Degree in Health Information Management preferred, RHIA or RHIT. Associate’s degree will be acceptable with education and experience relative to the size and scope of the organization.
      
    • Formal coursework in Anatomy and Physiology, Disease Process and Pharmacology.
      
  • Experience Requirements
    
    • Minimum of five (5) years of previous lead, supervisory or management experience.
      
    • Minimum of four (4) years of experience in IPPS hospital coding preferred.
      
    • Minimum of five (5) years of experience facility inpatient, same day surgery and OP facility coding preferred.
      
    • Previous experience using computerized systems for abstracting, coding, reports, and information storage and retrieval.
      
    • Experience with Excel spreadsheets, pivot tables and PowerPoint for educational presentations.
      
  • Special Skills or Training Requirements
    
    • Proficient with MS Word, Excel, PowerPoint, and MS Office.
      
    • Strong verbal and written communication skills.
      
    • Minimum typing skills of 35 characters per minute.
      
    • Ability to apply strong critical thinking and analysis skills.
      
    • Ability to mentor and train staff.