Coding Education & Quality Analyst

🔥 18 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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OhioHealth

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1891

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

OhioHealth is a not-for-profit healthcare system headquartered in Columbus, Ohio, dedicated to providing exceptional patient care and a wide range of medical services. With facilities spread across multiple locations, OhioHealth offers comprehensive healthcare services including cancer care, maternity, midlife clinics for women, virtual health appointments, and specialized care for transgender and LGBTQ patients. They also focus on patient education with health and wellness classes, support groups, and health quizzes. OhioHealth is committed to improving community health through various community relations and health initiatives. They provide resources such as price transparency, financial assistance, and patient rights information to enhance the healthcare experience for all patients.

📋 Description

• Conduct professional coding audits across inpatient, outpatient, observation, emergency department, vascular interventional radiology, hospital, rehabilitation, and clinic service lines • Conduct facility and charge-entry audits of Hospital, Neighborhood Care, Vascular Interventional Radiology, Rehab, and clinic coding records • Work with Clinical Documentation Improvement staff and Data Quality Engineers to ensure accurate capture and reporting of Hospital and Physician Quality Indicators • Monitor and track PQRI reports for practitioners and Operations staff • Research federal regulations, coding rules, regulations, and reference materials • Communicate coding and compliance updates to physicians, coding staff, management, and other relevant departments • Assist Coding Management and Failed Claims with coding- and documentation-related claim rejections and unbilled or billed claims • Ensure encounter forms are updated and compliant • Educate physicians, coders, failed claims specialists, clinical documentation specialists, and other departments on coding, billing, documentation, and compliance • Provide ICD-10-CM/PCS education across the OhioHealth System • Interact with medical staff regarding coding queries for Central Ohio Hospitals • Assist with development of cross-departmental policies and procedures • Evaluate quality and productivity of new hires and monitored coders, sharing results with coding management to support performance improvement and work improvement plans • Prepare and submit responses to third-party audits, including insurance-company audits

🎯 Requirements

• High School or GED required • One of the following certifications: CCS (Certified Coding Specialist), CCSP (Cisco Certified Security Professional), CPC (Certified Professional Coder), CPCH (Certified Professional Coder—Hospital), or RHIA (Registered Health Information Administrator) • 3 years of experience in coding • Knowledge of ICD-10-CM/PCS, coding, billing, clinical documentation, and coding compliance • Knowledge of federal regulations, coding rules, and payer requirements • Ability to conduct coding and documentation audits • Ability to prepare responses to third-party and insurance-company audits • Ability to educate physicians, coders, failed claims specialists, and clinical documentation specialists • Ability to collaborate with medical staff on coding queries • Work eligibility limited to Ohio for remote positions

🏖️ Benefits

• Full-time schedule with 40 scheduled hours per week • Day shift • Work from home in Ohio • Equal employment opportunity

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