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Senior Coding Data Quality Analyst - Facility Based

Role overview

Qualifications

  • High School Diploma/GED
  • 4 years of experience in coding/abstracting of complex patient encounters
  • Knowledge of ICD-10-CM/PCS, HCPCs/CPT, modifiers, charge applications, and reimbursement methodologies
  • CCA, CCS, CCS-P, CPC, or CPC-H certifications from AHIMA or AAPC

Responsibilities

  • Develops, implements, and maintains a coding and reimbursement quality management plan
  • Trains and educates coding and clinical staff
  • Conducts formal education and training for staff on policies/procedures, coding guidelines, and regulatory requirements
  • Evaluates the quality of clinical documentation to identify issues impacting code selection

Key facts

Other skills

  • Training And Development
  • Leadership
  • Communication
  • Teamwork

About the company

Lehigh Valley Health Network logo

Lehigh Valley Health Network

Hospitals & Health Care

At Lehigh Valley Health Network (LVHN), we continually go the extra mile to fulfill our mission to heal, comfort and care for the people of our community. Each one of our more than 18,000 colleagues contributes to this mission and helps make the Lehigh Valley a healthier – and better – place in which to live.You and your family deserve high-quality care, and we’re passionate about delivering it to you. We’re driven to do everything we can, every day, to ensure the care you need is available at Lehigh Valley Health Network. While we’re focusing on you, people from throughout the nation are focusing on us. We’ve received awards from national organizations recognizing us as one of the nation’s premier health networks.Many of the awards recognize us for providing superior care. For example, U.S News & World Report consistently ranks us in several areas. The expertise of our staff also is recognized. The American Nurses Credentialing Center names us a Magnet® Hospital, the highest honor for nursing excellence. Plus, the Leapfrog Group gives us an “A” for patient safety.We are humbled by such recognition and also are proud of our affiliations and accreditation.

Company details

Company typeXLarge
IndustryHospitals & Health Care
Company size9057 - 9057

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Job description

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. Trains and educates coding and clinical staff. Serves as a coding resource for the organization. Utilizes output for financial and billing purposes to meet licensure requirements, network quality initiatives, and public hospital and physician reporting.

Job Duties
  • Performs coding, monitoring, and auditing activities providing individual, departmental, and topic related results according to established schedule.
  • Conducts formal education and training for staff on policies/procedures, coding guidelines, regulatory requirements, and work processes. Provides feedback and develops educational action plans.
  • Establishes, implements, and maintains a formalized review process to support coding compliance.
  • Supports the manager in ensuring the completion of training of new employees and ongoing training of current employees.
  • Researches and responds to questions from the coding 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.
  • Demonstrates a clear understanding of purpose and objectives of department by keeping alert on current practices through journals, networking, and continuing education.

Minimum Qualifications
  • High School Diploma/GED
  • 4 years of experience in coding/abstracting of complex patient encounters.
  • Microsoft Office and presentation skills.
  • Medical terminology, anatomy and physiology, pathophysiology, regulatory agency requirements, severity of illness classification, and health care statistics computation.
  • Knowledge of ICD-10-CM/PCS, HCPCs/CPT, modifiers, charge applications, and reimbursement methodologies (DRG, APC).
  • Demonstrated leadership 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 Qualifications
  • Associate’s Degree in healthcare related field.
  • auditing experience and training background.

Physical Demands
Lift and carry 7 lbs., continuous sitting >67%, frequent keyboard use/repetitive motion, frequent fine motor activity/wrist position deviation.

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.

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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:

Monday-Friday; 8:00a-4:30p

Department:

1004-13058 COH-Him Facility Based Coding

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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