Coding Quality Review Educator

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This range is provided by Pride Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$40.00/hr - $45.00/hr

Direct message the job poster from Pride Health

Remote - Coding Quality Review Educator (Inpatient)

Pride Health is hiring a Coding Quality Review Educator for one of its clients based in Oklahoma.

This is a 3-month contract with a possible extension, with competitive pay and benefits.

This is a Fully Remote opportunity, but the candidate must be based in one of the following states: OK, KS, MO, TX, or AR.

Location – Remote

Pay range $40 - $45 per hour on W2.

Length of assignment 3 months (With Possible extension)

Shift – During the onboarding training process, hours are between 7:00-4:30 CST. After release to independent production scheduled time may be set between 6:00 AM and 6:00 PM CST.

Job Summary

Performs internal quality assessment reviews on the client’s coders to ensure compliance with national coding guidelines and the client’s coding policies for complete, accurate, and consistent coding, which results 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.

Job Duties

• 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 the client’s Medical System. Provides Coding Integrity Specialist (CIS) and CQR education as needed
• Initiates the rebilling process as required per policy on special projects
• Research coding opportunities and elevate as needed
• Assists in the review, improvement of processes, education, and troubleshooting, and recommends 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 to coding guidelines and policy. Demonstrates and applies expert-level knowledge of medical coding practices and concepts
• Participates in special reviews or projects
• Maintains or exceeds 95% productivity standards
• Maintains or exceeds 95% accuracy.

Education

• High School graduate or GED equivalent required.
• Undergraduate (associates or bachelor's) degree in HIM/HIT preferred.
• For Inpatient Audit position - must have extensive IP Coding experience and trauma coding. Prefer Academic Medical Center and Trauma Center experience.
• Pre-employment IP Coding and Auditing assessments are required before the interview.
• Minimum of 5 years acute care inpatient/outpatient coding experience required.
• Minimum of 3 years coding, auditing/monitoring experience strongly preferred.
• License(s)/Certification(s)/Registration(s) Required: RHIA, RHIT, CCS, or CPC required.

Equal Opportunity Employer

As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.

Seniority level

• Mid-Senior level

Employment type

• Contract

Job function

• Accounting/Auditing

Industries

• Hospitals and Health Care, Hospitals, and Medical Practices