Coding Quality Specialist I - Coding

The Coding Quality Specialist reports to the HIM Coding Education Manager to perform internal departmental coding reviews in support of the Coding Operations Department’s business needs. This position contributes to coding education and training and facilitates pre-bill and cross-training to advance and keep current, the skillset of our inpatient and outpatient HB coding Associates. The Coding Quality Specialist demonstrates high caliber specialty knowledge and understanding of current ICD-10-CM, ICD-10-PCS and/or CPT/HCPCS coding guidelines and practices in both the inpatient and outpatient care settings, maintaining a 95% accuracy rate. Assignments are based on departmental needs and include but are not limited to PEPPER reviews, new hire and standard pre-bill reviews, remediation and performance improvement reviews and those required for corrective action plans, query quality and other focused reviews as may be needed. The Coding Quality Specialists will review for quality in regards to POA assignment, principal and secondary diagnosis code assignment, procedural coding, modifier usage, discharge disposition verification, query opportunities and DRG and APC accuracy. Coding Quality Specialist will work collaboratively with various CHRISTUS Health Departments, including but not limited to the Regional Coding Managers, Coding Integrity, HIM, Compliance, and Clinical Documentation Specialist to ensure feedback is shared and reported for education and training purposes. The Coding Quality Specialist will also assist in production coding as may be required to keep current skills up-to-date and accustomed to changing technology and workflows. The Coding Quality Specialist will report directly to the HIM Coding Education Manager, with additional leadership from the Director of Coding Operations and System HIM Director.