POSITION SUMMARY:

Under the Supervision of the Outpatient Coding Manager, the Outpatient Coding Quality Analyst will assess the overall quality of coding on any accounts completed by the Outpatient Coding staff. Quality of coding can be evaluated either pre-bill or post-bill and ensures adherence to coding workflows, Official Coding Guidelines, and ethical coding. The incumbent will review medical records and provide Coding staff with feedback and coding advice.

The incumbent is responsible for designing and implementing quality coding audit programs and communicating audit findings to staff and Management. Audit work must be performed in compliance with standards for professional practice as identified in Official Coding Guidelines and any other applicable official resources.

As assigned by the Outpatient Manager and/or Supervisor, the incumbent has the authority to review and evaluate all coding areas within SwedishAmerican Hospital and outlying clinics as well as all coding areas within the University of Wisconsin Hospital and Clinics.

EDUCATION/TRAINING:

Minimum Education:

• Formal training in anatomy and physiology, medical terminology, and pathophysiology normally obtained in a one-year college level course of study.
• Formal training in the use of the ICD-10 diagnosis and CPT procedure coding system normally obtained through college level course of study

Preferred Education:

• Education beyond the minimum, either as formal courses of study or acquired through work experience
• Training in Microsoft Office applications such as Excel, Word, Power Point, etc.

LICENSURE/CERTIFICATION:

Coding related certification (e.g. CCS, COC, CPC, RHIT, RHIA, CCS-H)

OR

equivalent Coding experience with agreement to achieve certification within one year of hire into position

EXPERIENCE/SKILLS/ABILITIES:

Minimum Experience:

• Three years experience in auditing, training, or coding with at least one year of coding experience in an acute care hospital outpatient setting

Preferred Experience:

• Experience with coding quality improvement projects
• Training experience