[Hiring] Inpatient Coding Quality Education Review Specialist @Lifepoint Health

Role Description

The Coding Quality and Education Review Specialist will review accounts for accurate and appropriate coding and/or clinical documentation integrity (CDI) in accordance with the Company’s policies and procedures. Participates in the identification of educational areas for the company through the review process.

• Perform assigned coding quality reviews for all coding professionals (e.g., Lifepoint employed coders and contract coders) in adherence to:
• The American Health Information Management Association (AHIMA) Standards of Ethical Coding
• The Association of Clinical Documentation Improvement Specialist (ACDIS) Code of Ethics
• Official Coding Guidelines
• Lifepoint Health policies and procedures
• The International Classification of Disease tenth revision (ICD-10) rules and regulations
• The American Medical Association (AMA) Current Procedural Terminology (CPT) guidelines and rules for reporting
• Identify trends and recommend appropriate education for the coding professionals based on the findings of the coding quality reviews.
• Prepare audit summaries for reports for distribution to facility CFOs and compliance.
• Monitor assigned coding quality review schedules and progress of reviews; propose modifications as necessary to improve audit effectiveness and efficiency of the schedule.
• Serve as a coding resource for coding questions that are assigned.
• Uses independent discretion/decision making while effectively working alone.
• Attend educational webinars, conference calls, other coding seminars, and participate in all formal and informal coding discussions. Complete all assigned compliance courses within assigned period.
• Maintain at least twenty (20) continuing education hours annually and maintain required credentials.
• Conform to AHIMA’s Code of Ethics and Standards of Ethical Coding, LifePoint Attendance Policy and ensure patient/employee privacy and dignity by maintaining confidentiality with no infractions.
• Other related job tasks or responsibilities as assigned.

Qualifications

• Healthcare related Associate’s degree or any equivalent combination of education, experience, and training that provides the required knowledge, skills, and abilities; Bachelor’s degree preferred.
• Minimum five years’ experience, preferably in coding quality reviews and/or coding audits, with three years’ specific experience in Inpatient hospital coding.
• Familiarity with Diagnosis Related Groups (DRGs), Ambulatory Payment Categories (APCs), the Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative guidelines, Local and National Coverage Decisions and other medical necessity/compliance guidelines for billing and coding.
• Experience working with CDI team, writing queries, and working with multiple EMRs.
• Certifications: Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), or other comparable nationally recognized acute care coding credential provided through AHIMA or AAPC.

Requirements

• Must be work authorized in the United States without the need for employer sponsorship.

Benefits

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage—tailored benefit options for part-time and PRN employees, and more.
• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Professional Development: Ongoing learning and career advancement opportunities.