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Coding Quality Reviewer Educator Work From Home

Company name
The Board of Regents of the University of Oklahoma.

Oklahoma City, OK

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Description OU Medicine, Inc. - Oklahoma City, OK At OU Medicine, our mission is leading health care. Our vision is to be the premiere enterprise for advancing health care, medical education and research for the community, state and region. Through our combined efforts we strive to improve the lives of all people. General Description:\u00a0 Performs internal quality assessment reviews on OUMS coders to ensure compliance with national coding guidelines and the OUMS coding policiesfor complete, accurate and consistent coding which result 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. Essential Responsibilities: 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 OUMS Provides Coding Integrity Specialist (CIS) and CQR education as needed Initiates the rebilling process as required per policy on special projects Researches coding opportunities and escalate as needed Assists in the review, improvement of processes, education, troubleshooting and recommend 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 with coding guidelines and policy Demonstrates and applies expert level knowledge of medical coding practices and concepts Participates on special reviews or projects Maintains or exceeds 95% productivity standards Maintains or exceeds 95% accuracy Meets all educational requirements as stated in current Company policy Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical\/medical resources to assure coding knowledge and skills remain current Performs an annual education needs assessment as input to the strategic coding education program and provides this assessment to the Coding Leadership team Communicates Coding topics and\/or question trends to Coding Leadership for global education Coaches and mentors coding staff as they develop and grow their coding skills Provides skilled coding support through regularly scheduled coding meetings and as the need arises Researches external sources for common coding trends and questions Works on special projects as assigned Applies adult learning concepts when developing, delivering or assisting others for educational programs Provides high level of customer service Practices and demonstrates adherence to the Company\u2019s Code of Conduct and ethics philosophy and Company\u2019s Mission and Values Completes other duties as assigned\u00a0 Qualifications Minimum Qualifications : Education: High School graduate or GED equivalent required, undergraduate (associates or bachelors) degree in HIM\/HIT preferred Experience: Proven work experience in areas of coding education strongly preferred. Minimum of 5 years acute care inpatient\/outpatient coding experience required. Minimum of 3 years coding auditing\/monitoring experience strongly preferred. Licensure\/Certifications\/Registrations Required: RHIA, RHIT or CCS preferred Knowledge, Skills and Abilities: Coding Technical\/Professional Knowledge and Skills - extensive regulatory coding, (ICD-10-CM, ICD-10- PCS, CPT-4, Modifiers, MS-DRGs, POA assignment and where applicable APR-DRGs and APCs) and associated reimbursement knowledge Effective Decision Making - relating and comparing; securing relevant information and identifying key issues; committing to an action after developing alternative courses of action that take into consideration resources, constraints, and organizational values Adaptability to major changes in work responsibilities or environment; adjusting effectively to work within new work structures, processes, requirements, or cultures Initiative - independently takes prompt proactive steps toward problem resolution Contributing to Team Success by actively participating as a member of the team to move the team toward the completion of goals Work Standards \u2013setting high standards of performance for self and others; assuming responsibility and accountability for successfully completing assignments or tasks; self- imposing standards of excellence rather than having standards imposed Communication - communicates clearly and concisely, verbally and in writing. Customer Orientation - establishes and maintains long-term customer relationships, building trust and respect by consistentlymeeting and exceeding expectations. Interpersonal Skills - able to work effectively with other employees, patients and external parties. Data Analysis \u2013 able to analyze, interpret and share data in a presentation format. Knowledge of Healthcare Information - familiar with various types and sources of health care information, including financial and patient level data files. Work Independently , with experience working in a team environment. PC Skills - demonstrates proficiency in Microsoft Office applications and others as required. Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures, systems and query handbook.

Company info

The Board of Regents of the University of Oklahoma.

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