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Senior Coding Data Quality Analyst
Location
United States
Posted
17 days ago
Salary
0
Seniority
Senior
No structured requirement data.
Job Description
Senior Coding Data Quality Analyst
Lehigh Valley Health Network
Role Description Develops, implements, and maintains a coding and reimbursement quality management plan at the network level. Utilizes output for financial and billing purposes to meet licensure requirements, network quality initiatives, statistics, and for public hospital and physician reporting. Job Duties - Conducts formal education and training for staff on policies/procedures, coding guidelines, regulatory requirements, and work processes. - Provides feedback and develops educational action plans. - Performs code monitoring and auditing activities providing individual, departmental, and topic related results according to established schedule. - Researches and responds to coding questions from staff. - Evaluates the quality of clinical documentation to spot incomplete or inconsistent documentation impacting code selection. - Anticipates documentation issues in response to upcoming regulatory updates. - Maintains database for internal reporting of quality outcomes. - Establishes, implements, and maintains a formalized review process to support coding compliance. Qualifications - Associate’s Degree in health information management program or work experience in a complex coding environment, equivalent to Associates Degree. - 4 years of experience coding/abstracting of complex provider-based patient encounters. - Expert knowledge of ICD-10CM, HCPCS/CPT coding, modifiers, and reimbursement methodologies (wRVUs). - Microsoft Office and presentation skills. - CCA - Certified Coding Associate AHIMA - State of Pennsylvania Upon Hire or - CCS - Certified Coding Specialist AHIMA - State of Pennsylvania or - CCS-P - Certified Coding Specialist-Physician Based AHIMA - State of Pennsylvania or - CPC - Certified Professional Coder - State of Pennsylvania or - CPC-H - Certified Professional Coder-Hospital AAPC - State of Pennsylvania. Preferred Qualifications - Bachelor’s Degree in health information management program. - 1 year of experience auditing of provider-based coding. - 1 year of experience in provider-based coder training. - Knowledge of medical terminology, anatomy and physiology, pathophysiology, regulatory agency requirements, severity of illness classification, and health care statistics computation. Physical Demands - Lift and carry 25 lbs. - Frequent sitting/standing. - Frequent keyboard use. - Patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR. Work Shift Day Shift Address 1200 S Cedar Crest Blvd Primary Location REMOTE IN PENNSYLVANIA Position Type Remote Union Not Applicable Work Schedule 0700-1530 Department 1004-13044 COH-Risk Adjustment Coding
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Senior Auditor - Special Projects (Retail) Location: Remote, United States Full-time Department: Audit - Retail Job Description: Overview The Senior Retail Auditor position is responsible for developing new and existing audit concepts, gaining client acceptance, training all audit levels to execute audit projects and evaluating the effectiveness of audit concepts with the goal of auditing client data generating high quality recoverable claims for the benefit of Cotiviti and our clients. This specific position will entail multiple audit engagements per year to facilitate audit acceleration, process improvements, audit development, and new client onboarding. Responsibilities - Generate and Develop New Audit Concepts - Utilizes retail and auditing experience to perform audit procedures that include analyzing, identifying and defining issues, developing criteria, reviewing and analyzing evidence with the intent to audit standard medium - complex reports. 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