Coding Quality Specialist I - Coding Job at CHRISTUS Health (Irving)

Coding Quality Specialist I - Coding

The Coding Quality Specialist reports to the HIM Coding Education Manager to per...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High school diploma or equivalent years of experience required
Completion of accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred
Five (5) or more years of Inpatient and/or Outpatient HB coding experience in an acute care setting preferred
At least one of the following certifications are required: Registered Health Information Administrator (RHIA) (AHIMA)
Registered Health Information Technician (RHIT) (AHIMA)
Certified Coding Specialist (CCS) (AHIMA)
Certified Outpatient Coder (COC) (AAPC)
Certified Professional Coder (CPC) (AAPC)
Meets or exceeds an accuracy rate of 95%
Has strong written and verbal communication skills

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Facilitate and complete inpatient and outpatient coding reviews
Communicates findings both verbally and in writing in an approved, appropriate format to support training and education such as would be reported in Coding Roundtables or Section Meetings
Assist with development and coordination of review plans, education and training feedback to coding staff that may include query opportunities, documentation opportunities, accurate code assignment (ICD, CPT, HCPCS), accurate payment groupings (DRG, APC), accurate modifier assignment, accurate POA assignment, accurate discharge disposition assignment, compliance and data management
Assist with chart sample selection for reviews and randomization to be coordinated with Coding Managers
Assist with finalizing an annual education workplan for targeted chart reviews and pre-bill reviews
Work collaboratively with Coding Integrity Department to recommend and assist with content and examples that may be used to develop Job Aides, Coding Best Practice references and other assisting resources to support and advance coder knowledge and expertise
Reviews results and performs trend analyses to identify patterns and variations in coding practices and/or case-mix index which require education
Ensure coding reviews are appropriate and effective
Assesses effectiveness through associate evaluations

Fulltime

Hospital Coding Quality Specialist - Inpatient

Location

United States

Salary:

28.55 - 42.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA)
Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA)
Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA)
Associate's Degree in Health Information Management or related field
Typically requires 5 years of experience in hospital coding for a large complex health care system, which includes hospital coding, denial review and/or coding quality review functions
Demonstrated leadership skills and abilities
Demonstrates knowledge of National Council on Compensation Insurance, Inc. (NCCI) edits, and local and national coverage decisions
Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups)
Advanced knowledge in Microsoft Applications, including but not limited to
Excel, Word, PowerPoint, Teams

Job Responsibility

Reviews coded health information records to evaluate the quality of staff coding and abstracting, verifying accuracy and appropriateness of assigned diagnostic and procedure codes, as well as other abstracted data, such as discharge disposition
Ensure accurate coding for outpatient, day surgery and inpatient records
Verifies all codes and sequencing for claims according to American Hospital Association (AHA) coding guidelines, CPT Assistant, AHA Coding Clinic and national and local coverage decisions
Works collaboratively with coding leadership per their direction in reviewing records with focused diagnosis and procedure codes, including specific APCs, DRGs and OIG work plan targets to assure compliance in all areas of coding, which may give visibility into documentation that is driving codes
Works collaboratively with coding leadership to identify focused prospective records that need to be reviewed
Identifies coder education opportunities, team trends, and consideration of topics to mandate for second level account review, before the account is final coded
Reviews encounters flagged for second level review, including but not limited to
hospital acquired conditions (HACs), complications and other identified records such as core measures or trends as identified by coding leadership
Perform review of coded encounter for appropriate risk-adjustment, including accurate severity and risk of mortality assignment
Responsible for coding participation in the Clinical Documentation Improvement and Hospital Coding alignment process

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

New

Clinical Specialist, Quality Management I

Who We Are: Because health is personal. That's why Personify Health created the ...

Location

United States

Salary:

60600.00 - 91000.00 USD / Year

Personify Health

Expiration Date

Until further notice

Requirements

Active, unrestricted Registered Nurse (RN) license required
Basic computer literacy
The ability to work on multiple screens, and proficient typing skills
Proficiency in software applications including, but not limited to, Microsoft Word, Microsoft Excel, and Outlook
Ability to speak clearly and convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
Ability to work independently and utilize written resources to problem solve
After training with our training department and 1.5 months ramp (3 months total), must have and be able to work in: Teams on and off camera, SharePoint, Drives as needed, VPN, UM Web or Health Notes, El Dorado, Quick Links, GIAS, ADP, Confluence, Phone system with headset, Smartsheet
Knowledge of medical claims and ICD-10, CPT, HCPCS coding
Excellent verbal and written communication skills for upward and downward conversations
Level I: In-depth knowledge of applicable regulations and accreditation standards (HIPAA, CMS requirements as applicable, NCQA, URAC)

Job Responsibility

Ensure compliance with state, federal, and accreditation requirements (e.g., HIPAA, CMS, NCQA, URAC, ERISA, as applicable)
Conduct internal and external audits of UM/CM/CDM processes and documentation
prepare audit files, findings, and corrective action recommendations
Identify quality and compliance risks and collaborate with cross-functional partners on mitigation and resolution
Review and support SOPs and workflows to ensure regulatory alignment and operational clarity
Support external audit readiness activities, including NCQA and URAC evidence preparation and maintenance
Develop, maintain, and deliver role-based training curriculum aligned to compliance standards, quality goals, and operational workflows
Conduct onboarding and orientation to prepare staff for assigned UM/CM/CDM functions
Deliver training using multiple modalities (virtual, self-paced, and one-on-one coaching) tailored to adult learners
Ensure training covers applicable processes such as case initiation and closure, documentation standards, high-dollar case monitoring, stop-loss notification, administrative support, customer service, and productivity expectations

What we offer

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions (yes, we use what we build)
Unlimited PTO—rest and recharge time is non-negotiable
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets
Mission-driven culture where diverse perspectives drive real impact on people's health

Fulltime

Technical Quality Specialist

The Technical Quality Specialist is responsible for providing technical support ...

Location

Canada , Cambridge

Salary:

76000.00 - 104500.00 USD / Year

ATS Automation Tooling Systems Inc.

Expiration Date

Until further notice

Requirements

A post-secondary technology diploma or engineering degree or equivalent, specializing in electronics, electrical or mechanical engineering or equivalent work experience is required
A minimum of five years of quality assurance experience is required
Demonstrated technical problem solving
the ability to analyze and solve problems is essential
Strong communication skills are required to communicate with people at all levels within the organization, both orally and in writing
Ability to work cooperatively in a team environment
Strong data analysis skills

Job Responsibility

Assist process owners in the interpretation of quality, technical performance and business requirements
Develop, recommend and facilitate implementation changes to workflow
improve quality management system, review operational performance and provide solutions
Support the deployment of N299/ISO 9001 program and perform audits with associated RCCA activities
Inspection of incoming parts and associated supplier documentation
Review incoming unqualified/qualified source material for compliance with the Purchase Order and code requirements
Manage assigned projects in accordance with applicable standards, procedures and the gate review process
Analyze and prepare statistical data to determine capability of processes and measurement systems
Analyze test data as evidence to the degree of compliance to customer specifications
Investigate product/process/system quality issues, develop and initiate improvement, preventative actions and/or corrective actions

What we offer

Eligible for Annual Incentive Bonus
Stock Purchase Plan
3 Weeks Vacation
Health Care Benefits + $600 Health Care Spending Account
Employee Engagement Events (Employee BBQ’s and lunches, weekly snack day, etc.)
Employee Development Programs

Fulltime

Inpatient Coding Specialist

We are looking for an Inpatient Coding Specialist to join our team in Sacramento...

Location

United States , Sacramento

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in inpatient medical coding and familiarity with ICD-10-CM and ICD-10-PCS guidelines
Strong understanding of DRG assignment and reimbursement processes
Proficiency with coding software such as Epic, 3M Encoder, and related tools
Ability to interpret and abstract data from medical records accurately
Knowledge of federal and state regulations related to coding and billing
Excellent communication and collaboration skills to work effectively with clinical and administrative staff
Strong time management and problem-solving abilities to handle tasks independently
Commitment to maintaining coding accuracy and compliance with ethical standards

Job Responsibility

Accurately assign ICD-10-CM and ICD-10-PCS codes to inpatient records based on medical documentation
Ensure proper grouping into Medicare Severity Diagnosis Related Groups (DRG) or All Patient Refined Diagnosis Related Groups (APR-DRG) for optimal reimbursement
Abstract required data elements from medical records in alignment with facility-specific guidelines
Monitor discharged but not billed accounts to facilitate timely and compliant revenue cycle processing
Collaborate with clinical documentation specialists and medical staff to validate and enhance documentation
Maintain high standards of coding accuracy and productivity while adhering to quality benchmarks
Utilize software tools such as Epic, 3M Encoder, and other coding systems to validate and compile medical information
Analyze and ensure compliance with coding, billing, and data collection regulations
Address missing or unclear information by seeking clarification and ensuring proper documentation
Independently manage workload and prioritize tasks to meet departmental productivity standards

What we offer

medical, vision, dental, and life and disability insurance
eligibility to enroll in company 401(k) plan
free online training

Clinical Specialist, Quality Management & Training

The Clinical Compliance & Quality Specialist is responsible for ensuring regulat...

Location

United States , California

Salary:

60600.00 - 91000.00 USD / Year

Personify Health

Expiration Date

Until further notice

Requirements

Holds an active unrestricted Registered Nursing License Required
May require additional licensure
Bachelor’s Degree preferred
3-5 years UR, CM, DM experience required
Managed care experience preferred
CPHQ and/or CCM certification preferred
3 years of experience leading, mentoring, and training staff, with a strong ability to teach diverse audiences and adapt methods to varying learning needs
Completed advanced coursework in teaching and/or mentoring
In-depth knowledge of state and federal regulations, including HIPAA, CMS, NCQA, and URAC
Ability to interpret and apply evidence-based guidelines and accreditation standards to clinical operations

Job Responsibility

Ensure compliance with state, federal, and accreditation standards, including ERISA, NCQA, URAC, and HIPAA
Conduct internal and external audits of clinical programs, prepare detailed reports, participate in case file preparation and mark-up for audits
Monitor clinical trial activities to ensure protocol adherence and regulatory alignment
Identify and manage risks related to clinical quality and compliance, review and approve Standard Operating Procedures (SOPs), and collaborate with cross-functional teams to resolve quality issues and implement improvements
Train clinical staff on regulatory requirements, quality standards, and department objectives
Develop and maintain evidence-based training materials and software tools, and deliver training in various modalities (classroom, virtual, self-learning, and one-on-one) to adult learners with different levels of experience
Track and report training activities and employee progress, updating department leadership on staff who are not meeting expectations
Participate in quality audit programs and conduct monthly sample quality analysis audits to identify gaps and training opportunities
Support corrective action plans as directed by management and provide comprehensive follow-up
Maintain current knowledge of industry regulations, accreditation standards, and evidence-based practices to support staff education

What we offer

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions (yes, we use what we build)
Unlimited PTO—rest and recharge time is non-negotiable
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets
Mission-driven culture where diverse perspectives drive real impact on people's health

Fulltime

Medical Coding Specialist

The Medical Coding Specialist is responsible for obtaining charge capture data f...

Location

United States , Salina

Salary:

Not provided

Central Care Cancer Center

Expiration Date

Until further notice

Requirements

Previous clinical or coding experience
At least 2 years’ experience of medical billing in a Healthcare setting and CPC, required
CEMC, CPMA, and CHONC certifications preferred
Knowledge of CPT and ICD10 coding
Knowledge of HIPAA and OSHA rules and regulations
Knowledge of insurance fee schedules and contractual obligations
Problem Solving
Maintains confidentiality
Balances team and individual responsibilities
Displays willingness to make decisions

Job Responsibility

Obtaining charge capture data from the electronic medical records (EMR) and keying this information into the patient management system daily for multiple assigned locations
Review medical notes and records to identify proper coding of claims
Assigns and translate codes for different services and diagnosis
Review physicians’ notes and charts for accuracy
Maintain current knowledge of coding and keep current with medical compliance and reimbursement policies impacting claims payments
Responsible for daily entering and organizing of codes from EMR into billing management software
Familiar with ICD10 and CPT/HCPCS universal coding systems
Obtains necessary clarification with clinical managers and nursing staff to ensure appropriate billing and charge capture
Manage and track missing charge capture reports or billing information, ensuring timely entry of information prior to month end
Monthly audit of assigned locations (10% of charts)

Fulltime

Inpatient Coding Specialist

This contract position involves reviewing and analyzing medical records to accur...

Location

United States , Sacramento

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proven experience in inpatient medical coding and familiarity with ICD-10-CM and ICD-10-PCS guidelines
Strong understanding of DRG assignment and reimbursement processes
Proficiency with coding software such as Epic, 3M Encoder, and related tools
Ability to interpret and abstract data from medical records accurately
Knowledge of federal and state regulations related to coding and billing
Excellent communication and collaboration skills to work effectively with clinical and administrative staff
Strong time management and problem-solving abilities to handle tasks independently
Commitment to maintaining coding accuracy and compliance with ethical standards

Job Responsibility

Accurately assign ICD-10-CM and ICD-10-PCS codes to inpatient records based on medical documentation
Ensure proper grouping into Medicare Severity Diagnosis Related Groups (DRG) or All Patient Refined Diagnosis Related Groups (APR-DRG) for optimal reimbursement
Abstract required data elements from medical records in alignment with facility-specific guidelines
Monitor discharged but not billed accounts to facilitate timely and compliant revenue cycle processing
Collaborate with clinical documentation specialists and medical staff to validate and enhance documentation
Maintain high standards of coding accuracy and productivity while adhering to quality benchmarks
Utilize software tools such as Epic, 3M Encoder, and other coding systems to validate and compile medical information
Analyze and ensure compliance with coding, billing, and data collection regulations
Address missing or unclear information by seeking clarification and ensuring proper documentation
Independently manage workload and prioritize tasks to meet departmental productivity standards

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

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Coding Quality Specialist I - Coding

Job Description

Job Responsibility

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Coding Quality Specialist I - Coding

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