HIM Cert Coder, Quality Review Analyst

🕒 April 22

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $24 - $40 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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Carle Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1946

⚕️ Healthcare Insurance

📚 Education

Healthcare Insurance • Healthcare • Education

Carle Health is a comprehensive healthcare provider dedicated to managing the health needs of its community. Offering a wide range of services, from general medical care to specialized treatments in oncology, cardiovascular, pediatrics, and women's health, Carle Health emphasizes quality patient care and community health initiatives. Additionally, it supports education and research through the Carle Illinois College of Medicine and engages in community health programs that aim to improve overall well-being.

📋 Description

• Perform accurate and timely quality reviews of internal and vendor coding team members using appropriate code sets and coding guidelines. • Develop and perform timely coding education to internal and vendor coding team members on coding systems, coding standards, protocols and Carle coding workflow as required based on quality review outcomes. • Perform as a production coder when needed in a manner aligned with current coding productivity and quality standards. • Share results of quality reviews to HIM Leadership with recommendations for education and training. • Compile and track statistics related to the review function, completed quality reviews, and follow up from those reviews. • Identify coder training needs, system issues, and/or documentation issues and report them timely to HIM leadership. • Review and respond to coding denials and coding questions as requested or assigned and perform clinical validation of appeal letters as needed. • Participate in system and new application testing as needed. • Provide denial trending data to leadership as requested. • Develop and perform HIM coding team member group education on coding topics identified during quality reviews and denial reviews.

🎯 Requirements

• Certified Professional Coder (CPC) - AAPC • Certified Coding Associate (CCA) - AHIMA • Certified Coding Specialist (CCS) - AHIMA • Registered Health Information Administrator (RHIA) - AHIMA • Registered Health Information Technician (RHIT) - AHIMA • Certified Professional Coder - Payer (CPC-P) - AAPC • Certified Professional Coder - Hospital (CPCH) - AAPC

🏖️ Benefits

• Comprehensive benefits package