[Remote] Senior Coding Data Quality Analyst - Provider Based
Note: The job is a remote job and is open to candidates in USA. Lehigh Valley Health Network is a nationally recognized health organization committed to delivering exceptional healthcare. The Senior Coding Data Quality Analyst will develop and maintain a coding and reimbursement quality management plan, ensuring compliance and quality outcomes through education, monitoring, and auditing activities.
Responsibilities
- Conducts formal education and training for staff on policies/procedures, coding guidelines, regulatory requirements, and work processes. Provides feedback and develops educational action plans
- Performs code monitoring and auditing activities providing individual, departmental, and topic related results according to established schedule
- Researches and responds to coding questions from staff
- Evaluates the quality of clinical documentation to spot incomplete or inconsistent documentation impacting code selection. Anticipates documentation issues in response to upcoming regulatory updates
- Maintains database for internal reporting of quality outcomes
- Establishes, implements, and maintains a formalized review process to support coding compliance
Skills
- Associate's Degree in health information management program or work experience in a complex coding environment, equivalent to Associates Degree
- 4 years of experience coding/abstracting of complex provider-based patient encounters
- Expert knowledge of ICD-10CM, HCPCS/CPT coding, modifiers, and reimbursement methodologies (wRVUs)
- Microsoft Office and presentation skills
- CCA - Certified Coding Associate AHIMA - State of Pennsylvania Upon Hire or
- CCS - Certified Coding Specialist AHIMA - State of Pennsylvania or
- CCS-P - Certified Coding Specialist-Physician Based AHIMA - State of Pennsylvania or
- CPC - Certified Professional Coder - State of Pennsylvania or
- CPC-H-Certified Professional Coder-Hospital AAPC - State of Pennsylvania
- Bachelor's Degree in health information management program
- 1 year of experience auditing of provider-based coding and
- 1 year of experience in provider-based coder training
- Auditing and training
- Knowledge of medical terminology, anatomy and physiology, pathophysiology, regulatory agency requirements, severity of illness classification, and health care statistics computation
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