Coding Services Quality Analyst

Position Summary

The Coding Services Quality Analyst ensures the accuracy, compliance, and quality of medical coding and documentation within healthcare records. This role is essential in maintaining regulatory standards, supporting accurate coding processes, and minimizing compliance risks. The Quality Analyst collaborates with the Coding Services Manager and Director. The Quality Analyst will provide feedback and necessary training as needed.

Quality Assurance and Auditing

• Perform regular audits of coded medical records to ensure compliance with ICD-10, CPT, and HCPCS standards.
• Identify and correct coding errors to optimize coding accuracy and minimize denials.
• Evaluate documentation to confirm it supports the assigned codes.

Compliance Monitoring

• Monitor coding practices for adherence to federal and state regulations, including HIPAA, CMS guidelines, and other applicable standards.
• Support the organization in maintaining compliance with internal policies and external audits.

Data Analysis and Reporting

• Compile audit results and prepare detailed reports to identify trends, gaps, and areas for improvement.
• Track quality metrics and provide recommendations for process enhancements.

Education and Training

• Provide feedback and training to medical coders on identified errors and best practices.
• Assist in the development and delivery of educational materials on coding updates and guidelines.

Certifications and Experience

• Certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required.
• Education: Associate's or Bachelor's degree in Health Information Management, or a related field (preferred).
• Experience:
  • Minimum 5 years of experience in medical coding.
  • Minimum 5 years of experience auditing coded records.
  • Minimum 3 years of experience mentoring staff.
• Skills: Familiarity with various EHR systems and coding software. Strong understanding of medical terminology, anatomy, and coding guidelines (ICD-10, CPT, HCPCS). Strong communication and interpersonal skills to provide constructive feedback. Ability to manage time and prioritize tasks effectively. Proficiency in Windows, Excel, Word, PowerPoint. Strong ability to troubleshoot. Experience working with diverse teams and a global workforce.

Work Environment

This position may involve remote, hybrid, or in-office work depending on organizational needs. Regular access to secure systems for coding review is required.

What We Offer

• A competitive compensation commensurate with experience, along with a comprehensive benefits package including medical, dental and vision insurance, 401(k) retirement plan, Health Savings Account (HSA), and generous PTO and holiday pay.
• AAPC is an Equal Opportunity Employer. This company does not and will not discriminate in employment and personnel practices on the basis of race, sex, age, disability, religion, national origin, or any other basis prohibited by applicable law. Hiring, transferring and promotion practices are performed without regard to the above-listed items.