Texas Health Resources Jobs

Texas Health Career Site

Job Information

Texas Health Resources Lead Coding/Education Quality Analyst Inpatient - Full Time Days - Arlington in Arlington, Texas

Texas Health Resources seeks to hire a Lead Coding/Education Quality Analyst Inpatient to work Full Time Days with the Health Information Management Department.

The address is 500 E. Boarder Street, Arlington, TX 76010.

*Currently working remote*

Salary range is Min: $28.73/hour to Max: $47.28/hour – based on relevant experience.

Work Hours/Schedule

  • Full Time; 40 hours/week

  • Monday – Friday, 8:00 am – 4:30 pm; flexible hours based on business needs

Job Description

Audits documentation and validates the accuracy of diagnosis and procedure coding for accurate DRG or APC assignment and medical necessity. Collaborates with the Clinical Documentation Integrity (CDI) staff to improve documentation. Assists coding management with all processes associates with achieving the weekly CFB goals.

Performs audits of medical records and validates assignment of diagnosis and procedure codes:

  • Assesses accuracy of principle diagnosis and APC assignment.

  • Confirms appropriate coding and sequencing of pertinent secondary diagnoses and procedures.

  • Confirms coding of all diagnoses required to validate medical necessity.

  • Validates the use or none use of queries.

  • Reviews audits with manager and lead analyst prior to coder; distributes audit communication to coders and coordinates rebuttal and rebill processes with coders post audit reviews.

  • Monitors for coder error trends in reviews and advises manager and lead analyst of identified trends/patterns.

  • Identifies issues that relate to the clinical department and/or physician documentation and submits to denials management.

  • Reconciles discrepancies with appropriate clinical department, Quality etc.

  • Provides coding review summary reports to management as required.

Assists the management team with employee development/education and organizational improvement:

  • Provides feedback to employee on identified issues found during record review with supportive documentation as needed.

  • Responds in a timely manner to coder requests for assistance.

  • Provides manager with quality and quantity performance data for use in performance reviews. Provides input into staff evaluations.

  • Monitors for trends during review process and advises appropriate manager of identified trends/patterns reflecting need for individual action plan(s) or section education.

  • Assists with the development of actions plans and implements with the oversight of the manager.

  • Assists in the development and updating of procedures to maintain standards for correct coding.

  • Participates in coder interviews.

  • Collaborates in the education and training of new coding employees.

  • Provides input in the development, refinement and implementation of methods and procedures used to for coder education and training.

  • Contributes to the development of educational/training opportunities for physicians and hospital clinical staff.

  • Participates in committee work and cross functional teams as needed by department management.

Assists the management team with Fiscal Management of coding resources and processes:

  • Assists manager with the processes associated with the weekly CFB volume to consistently meet entity/system targets providing backup coverage for coding staff as needed.

  • Analyzes and adjusts workload responsibilities based on changes in staffing/volumes, etc.

  • Assists with requests to verify and review codes and charges on patient accounts and denials.

  • Assists manager in monitoring and reporting coder productivity and quality.

  • Assists coding staff in resolving ITS issues impacting work efficiently by facilitating ticket submission.

  • Pursues knowledge and participation in HFMA, AAPC and AHIMA organizations.

Assists the management team in Quality and organizational improvement:

  • Maintains database of audit review results and provides individual and summary reports to management and staff as required.

  • Provides monthly/quarterly summary review of activities and findings to manager.

  • Develops and/or refines policies and procedures identified during the audit review process.

  • Keeps abreast of all changes to payer coverage determination policies and regulatory documentation requirements.

  • Collaborates with coding managers and CDMP staff to address opportunities to improve review and query processes.

  • Collaborates with denials team on education opportunities for clinical departments.

  • Assists the manager in forming and leading committees and cross functional teams as needed.

  • Leads or facilitates special projects to enhance professional coding expertise. Seeks opportunities for professional presentations and publications and helps other in their pursuits.

  • Provides education to physicians and clinicians to improve documentation.

Serves as subject matter expert to coding employees:

  • Stays current on coding guidelines as published in Coding Clinic and CPT Assistant.

  • Maintains knowledge of regulatory requirements, payer coverage determinations.

  • Demonstrates initiative in identifying areas requiring further research.

  • Completes of all hospital required training and education in a timely manner.

  • Completes ICD 10 education modules and provides feedback to coding employees.

  • Serves as a knowledge expert in the areas of documentation, ICD-10, CPT,PCS, HCPCS, and modifiers.

Professional accountability:

  • Maintains frequent and regular contact with manager and seeks consultation and guidance when appropriate.

  • Participates in personal annual performance evaluation, providing opportunity for growth and development.

  • Seeks out opportunities to provide education to department and hospital staff.

  • Consistently abides by the Standards of Ethical Coding as set by AHIMA and adheres to official coding guidelines.

  • Maintains certification with CE credits.

Qualifications

The ideal candidate will possess the following qualifications:

  • Bachelor’s Degree required or

  • Associate’s Degree in Health Information Services or related field and 2 years coding experience and demonstrated proficiency in lieu of degree required or

  • High School Diploma or Equivalent and 4 years Coding experience and demonstrated proficiency in lieu of degree required.

  • 5 year of coding in acute care setting with evidence of progression in coding responsibilities required.

  • 1 year experience performing coding and documentation audits preferred.

Licenses and Certifications:

  • RHIA – Registered Health Information Administrator within 12 months required or

  • RHIT – Registered Health Information Technician within 12 months required or

  • COC – Certified Outpatient Coder within 12 months required or

  • CCS – Certified Coding Specialist within 12 months required

Skills

  • Proficient in software applications (Excel, Word, Optum CAC, EPIC).

  • Thorough knowledge of ICD 10-CM, PCS and CPT.

  • Expert in coding convention/automated encoder (knowledge management of NCCI/OCE billing edits).

  • Knowledgeable in APC and DRG methodologies and all regulatory/payer requirements associated with coding.

  • Demonstrated knowledge of and ability to apply THR coding policies and procedures to record review process.

  • Demonstrated time management and organizational skills.

  • Demonstrated clear and concise oral and written communication skills.

  • Demonstrated strong decision making and problem-solving skills.

  • Personal initiative to keep abreast of new developments in coding updates/technology/research/regulatory data.

  • Successful completion of ICD 10 training and certification.

Why Texas Health Resources?

Texas Health Resources is one of the largest faith-based, nonprofit health care delivery systems in the United States and the largest in North Texas in terms of patients served.

Texas Health has 25 acute-care and short-stay hospitals that are owned, operated, joint-ventured or affiliated with the system. It has more than 3,800 licensed beds, more than 21,100 employees of fully-owned/operated facilities plus 1,400 employees of consolidated joint ventures and counts more than 5,500 physicians with active staff privileges at its hospitals.

At Texas Health, we strive to create an atmosphere of respect, integrity, compassion and excellence for all who come in contact with us, be they patients or our employees. We are committed to diversity in our workforce, and our mission to serve spreads across ethnic, cultural, economic and generational boundaries. We invite you to join us in furthering your career through our accomplishments and philosophy of excellence.

Texas Health Highlights

  • 2020 FORTUNE Magazine’s “100 Best Companies to Work For®” (6 th year in a row)

  • 2018 Becker's Healthcare "150 Great Places to Work in Healthcare" (4 th year in a row)

  • Employees’ Choice “Best Places to Work” by Glassdoor (2018 & 2019)

Employment opportunities are only reflective of wholly owned Texas Health Resources entities.

We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

DirectEmployers