Coding Inpatient Quality

Coding Inpatient Quality Reviewer / Educator (Work From Home)

Position Title : Coding Inpatient Quality Reviewer / Educator (Work From Home)

Department : HIM Coders

Job Description : This position may be performed remotely anywhere within the United States except the States of Arizona, California, Connecticut, Illinois, New Jersey, New York, Pennsylvania, or Washington

General Description : Performs internal quality assessment reviews on OUMS coders to ensure compliance with national coding guidelines and the OUMS coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. Helps to coordinate and direct the day-to-day coding educational activities. Facilitates and provides coding educational classes / presentations to staff, as required / when needed. Communicates outcomes to the coding team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. Responsibilities also include assisting Coding Leadership in root cause analysis of coding quality issues, performing account reviews, and preparing training documents to assist with coding quality action plans.

Essential Responsibilities :

• Responds to coding-related questions from HSC coding staff
• Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven) for inpatient and outpatient coding across OUMS
• Provides Coding Integrity Specialist (CIS) and CQR education as needed
• Initiates the rebilling process as required per policy on special projects
• Researches coding opportunities and escalate as needed
• Assists in the review, improvement of processes, education, troubleshooting and recommend prioritization of issues.
• Provides and creates education as needed
• Monitors QA results to assist Coding Leadership in root cause analysis and educational opportunities
• Assists with curriculum development
• Assists in ensuring coding staff adherence with coding guidelines and policy
• Demonstrates and applies expert level knowledge of medical coding practices and concepts
• Participates on special reviews or projects
• Maintains or exceeds 95% productivity standards
• Maintains or exceeds 95% accuracy
• Meets all educational requirements as stated in current Company policy
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical / medical resources to assure coding knowledge and skills remain current
• Performs an annual education needs assessment as input to the strategic coding education program and provides this assessment to the Coding Leadership team
• Communicates Coding topics and / or question trends to Coding Leadership for global education
• Coaches and mentors coding staff as they develop and grow their coding skills
• Provides skilled coding support through regularly scheduled coding meetings and as the need arises
• Researches external sources for common coding trends and questions
• Works on special projects as assigned
• Applies adult learning concepts when developing, delivering or assisting others for educational programs
• Provides high level of customer service
• Practices and demonstrates adherence to the Company's Code of Conduct and ethics philosophy and Company's Mission and Values
• Completes other duties as assigned

General Responsibilities :

Minimum Qualifications :

Education : High School graduate or GED equivalent required, undergraduate (associates or bachelors) degree in HIM / HIT preferred.

Experience : Proven work experience in areas of coding education strongly preferred. Minimum of 5 years acute care inpatient / outpatient coding experience required. Minimum of 3 years coding auditing / monitoring experience strongly preferred.

Licensure / Certifications / Registrations Required : RHIA, RHIT, CCS, or CPC required

Knowledge, Skills and Abilities :

OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.