Inpatient Coding Quality Review / Educator (WFH)

Position Title :

Inpatient Coding Quality Review / Educator (WFH)

Department : HIM Coders

Job Description :

This position may be performed remotely from the following locations within the United States of America :

Arkansas,

Kansas, Missouri, Oklahoma, and Texas.

Please only apply if you live and work full-time in one of the states listed above or plan to relocate to one of these states before starting your employment with OU Health.

State locations and specifics are subject to change as our hiring requirements shift.

General Description :

Performs internal quality assessment reviews on OUH coders to ensure compliance with national coding guidelines and the OUH 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 :

Responsibilities listed in this section are core to the position.

Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position.

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 :

Performs other duties as assigned

Minimum Qualifications

Education :

High school diploma or GED required. Associate's or Bachelor's degree in HIM / HIT preferred.

Experience :

Minimum of five (5) years acute care inpatient / outpatient coding experience required. Three (3) years coding auditing / monitoring experience strongly preferred.

License(s) / Certification(s) / Registration(s) Required :

RHIA, RHIT, CCS, or CPC required.

Knowledge, Skills and Abilities :

Coding Technical / Professional Knowledge and Skills

• extensive regulatory coding, (ICD-10-CM, ICD-10- PCS, CPT-4, Modifiers, MS-DRGs, POA assignment and where applicable APR-DRGs and APCs) and associated reimbursement knowledge

Effective Decision Making

Adaptability

to major changes in work responsibilities or environment; adjusting effectively to work within new work structures, processes, requirements, or cultures

Initiative

Contributing to Team Success

by actively participating as a member of the team to move the teamtoward the completion of goals

Work Standards

Communication

Customer Orientation

Interpersonal Skills

Data Analysis

Knowledge of Healthcare Information

Work Independently

, with experience working in a team environment.

PC Skills

Policies & Procedures

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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.