Coding Quality Analyst

Primary Responsibilities

• Adheres to approved schedule and arrives at work timely
• Maintains accurate accounts of time off in both Verint and HR Direct as per guidelines, and follows directives for time off, schedule changes, etc.
• Follows directive of composing appeal letters to include appropriate data extraction, construction of well-written appeals letters with proper grammar, utilization of appeal tools including pre-constructed templates, and inclusion of appropriate medical literature references
• Use and fluency of encoders, coding clinics, ICD-9 and 10 guidelines, CM and PCS, CPT coding system and HCPCS guidelines
• Working knowledge of Word
• Effective communication skills
• Excellent typing skills with a minimum speed of 45/min
• Adheres to company policies and procedures as well as policies, procedures, and laws
• Understands and complies with HIPAA confidentiality requirements
• Support and promote OPAS, Optum, and the enterprise goals and mission
• Build relationships across Optum, OPAS, OGA and our clients
• Collaborate with peers to assure continuity of communication and execution of deliverables as needed
• Adheres to quality and productivity expectations
• Participate in and contribute to meetings as appropriate
• Maintains organization on the team and ensures everyone conducts themselves professionally
• Remains up to date with all learning modules, competencies, and state required licenses
• Performs other related duties, tasks, and processes as required by leadership
• Ability to establish priorities, be self-motivated, work independently, and follow instructions with supervision and structure
• Positive attitude and the ability to function as a collaborative team member

Required Qualifications

• High School Diploma/GED
• Possess one of the following coding certifications - CCS, CCS-P, CPC-H, CPC, RHIT, RHIA, CDIP, CCDS
• 3+ years of Inpatient Hospital Coding experience
• 3+ years of experience with DRG methodology
• 3+ years of outpatient coding experience
• 2+ years of Medicare/Medicaid experience
• Mastery level of knowledge of AHA Coding Clinic for ICD-9-CM and ICD-10
• Intermediate level of computer proficiency with strong typing skills (minimum of 45 wpm)

Preferred Qualifications

• Associate's or Bachelor's Degree
• Unrestricted RN license required in state of residence
• 3+ years of experience in ED, Telemetry, CCU
• Auditing experience
• Experience with Microsoft applications and software, internet navigation and utilization
• Previous experience with presenting before Administrative Law Judge

Soft Skills

• Strong, effective verbal and written communication skills