Senior Coding Data Quality Analyst - Provider Based
Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.
Summary
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 DutiesConducts 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. Minimum QualificationsAssociate’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 QualificationsBachelor’s Degree in health information management program. 1 year of experience auditing of provider-based coding and 1 year of experience in provider-based coder training. Auditing and 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.
Job Description
Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require. Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities. https://youtu.be/GD67a9hIXUY Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location. Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes. 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 Apply To This Job