Scope of Position
After medical records are coded in Medical Information Management (MIM), the Coding Quality Analyst is responsible for ensuring accuracy of coding via random or focused auditing of medical records.
In addition, the analyst is responsible for completing claim/coding edits and responding to requests from the Central Business Office (CBO) regarding documentation required for compliance with CMS National Correct Coding Initiative (NCCI) and Outpatient Code Editor (OCE) edits.
The analyst is responsible for providing feedback to the Director of Outpatient Coding and Compliance regarding recommendations for improving coding accuracy and compliance.
Position Summary:

Position eligible for flexible hybrid remote work schedule.
The position is responsible for coding quality improvement and claim/coding edit resolution. This staff member reviews randomly selected and focused medical records for accurate selection of appropriate admitting and discharge diagnoses ICD-9-CM/ICD-10-CM, ICD-9-CM/CPT4 procedures. The analyst uses the encoding and abstracting system and other resources to ensure complete and accurate coding for hospital reimbursement, research and planning. The analyst uses responses such as system, spreadsheets, and automation to report all audit activities.
In addition, this staff member utilizes approved claim/coding resolution reference material that includes, at minimum the NCCI database, Craneware, and charge description master file updates (provided by OSUWMC revenue cycle management team) to resolve claim/coding edits. The analyst follows standard operating procedures in regards to updating IHIS accounts and accurately modifying charges.
The analyst advises medical record coding specialist on coding guidelines and compliant practices, as requested.
Organizational Expectations
Employee must practice within the Health System's policies and procedures. Adheres to the Medical Centers values as demonstrated by striving for excellence, collaborating as One University, demonstrating integrity and personal accountability, openness, and trust, promoting diversity in people and ideas, change and innovation, simplicity in our work, empathy and compassion, and leadership.
Employee complies with the AHIMA Code of Ethics and Standards of Ethical Coding. Employee complies with the Department of Medical Information Managements Standards of Conduct on Billing and Coding.
Minimum Qualifications
For Hire:
Minimum Qualifications
For Hire:
Required: Associate degree in Health Information Management, and a minimum of 3-5 years medical center outpatient coding experience (ICD10CM and CPT) for service types such as emergency, outpatient, ambulatory surgery, observation, and series/clinics. Bachelor's degree in Health Information Administration or equivalent degree preferred.
Considerable progressively responsible administrative medical information management experience required knowledge and experience with electronic health records and health information management applications required.
Certifications can include: Registered Health Information Record Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS) by the American Health Information Management Association, COC (outpatient credential only).
Ongoing:
Maintain continuing education credits as required by the American Health Information Management Association. Attend coding and department meetings as well as timely completion of hospital CBLs.
Certification
RHIA, RHIT, CCS, or COC (outpatient credential only)