Coding Quality Analyst-Facility Inpatient

Posted:
11/10/2024, 4:00:00 PM

Location(s):
Southfield, Michigan, United States ⋅ Michigan, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Customer Success & Support

Workplace Type:
Hybrid

Job Summary

Responsibility for coordination of employees and processes in assigned areas of HIM Clinical Coding, and Coding Audit; Inpatient, Outpatient, Emergency and Professional Coding Performs quality and compliance audits. Reviews medical record documentation to determine coding accuracy.

Essential Functions

Oversees variety of duties which can include: serves as an expert coding resource for HIM Management, service line coders, office staff and physicians. (Facility and Professional coding), review of denials and rejections including HIM work queues, complex coding issues, and quality initiatives.

  • Maintains expert coding knowledge (ICD-10-CM/PCS, CPT/HCPCS) and understanding of government regulations, third party payor requirements and various reimbursement methodologies (MS-DRG, APR-DRG, APC, Rehab CMG, RVU).

  • Coordination of staff’s day to day operations, assists in trouble shooting issues, problem solving and resolution of customer service and/or billing issues. Identify problematic coding trends based on audit activity to provide ongoing training and education.

  • Monitors goals & objectives for assigned area to assist in achieving turnaround times, staff productivity and quality.

  • Assists in interviews, training, counseling, audits, and evaluating performance of staff.

  • May compile statistics, weekly & monthly reports and employees schedules.

  • Coordinates responses to payor audits for reconsideration process (appeal preparation).

  • Review and complete uncoded accounts in follow up and uncoded workques.

  • And other assigned duties.

Qualifications

Required

  • Associate degree in health information management or equivalent relevant work experience required.

  • 3 years of relevant experience Minimum of 3 years of hospital and/or professional coding experience.

Certifications required, 1 of 3

  • CRT-Coding Specialist (CCS) - AHIMA American Health Information Management Association.

  • CRT-Registered Health Information Administrator (RHIA) - AHIMA American Health Information Management Association.

  • CRT-Registered Health Information Technician (RHIT) - AAPC American Academy of Professional Coders.

How Corewell Health cares for you

  • Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.

  • On-demand pay program powered by Payactiv

  • Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

  • Optional identity theft protection, home and auto insurance, pet insurance

  • Traditional and Roth retirement options with service contribution and match savings

Primary Location

SITE - Beaumont Service Center - 26901 Beaumont Blvd

Department Name

Coding - Quality

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

Variable

Days Worked

Monday to Friday

Weekend Frequency

N/A

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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.