Integrity Analyst - PB Coding Quality Medical Specialties

Responsibilities

• Research, interpret, and apply coding, payer, and regulatory requirements to support accurate and compliant Professional and Hospital coding practices.
• Develop, maintain, and update coding guidance, standard work, reference materials, and position statements to ensure enterprise consistency.
• Coordinate and support coding quality audits by routing requests, maintaining records, and verifying documentation completeness and accuracy.
• Track audit findings, quality issues, and compliance risks, documenting patterns and supporting corrective actions.
• Analyze coding quality data and audit results to identify trends, risks, and opportunities for improvement.
• Prepare summaries, reports, and materials for leadership, audit reviews, and quality improvement initiatives.
• Partner with Integrity Operations, coding leadership, clinicians, and education teams to improve documentation quality and coding accuracy.
• Support regulatory, compliance, and quality-related projects, ensuring adherence to organizational policies and AHIMA coding standards.
• Respond to internal inquiries related to coding guidance, quality findings, and audit outcomes.
• Support testing, reporting validation, and workflow updates related to coding quality, guidance, and compliance initiatives.

Requirements

Education: Associate degree or equivalent education and experience required.

• Coding credentials required. Certification from American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) such as RHIA, RHIT, CCS, CCS-P, or CPC.
• 5 years of experience in expert-level professional coding or hospital-based coding and experience in revenue cycle processes, health information workflows, and medical record auditing.
• Advanced knowledge of ICD, CPT, and HCPCS coding guidelines.
• Advanced knowledge of medical terminology, anatomy, and physiology.
• Advanced ability to identify coding quality issues/concerns and provide recommendations for improvement.
• Advanced ability to analyze trends and data and display them in a statistical reporting format.
• Advanced organization and communication (verbal and written) skills.
• Advanced ability to effectively train others through oral and/or written methods.
• Advanced organization, prioritization, and reading comprehension skills.
• Advanced analytical skills, with high attention to detail.
• Advanced knowledge of Microsoft Office, video and web conferencing, email, and experience with electronic coding and EHR systems or applications.
• Advanced knowledge of care delivery documentation systems and related medical record documents.
• Advanced interpersonal communication skills (oral and written) necessary to collaborate with Physicians, other clinicians, and Professional Coding Department team members and leadership.
• Ability to work independently and exercise independent judgment and decision-making.
• Ability to meet deadlines while working in a fast-paced environment.
• Ability to take initiative and work collaboratively with others.
• Strong sense of ethics.
• Experience with remote workforce operations required.

Physical Requirements and Working Conditions

• Position requires travel which will result in exposure to road and weather hazards.
• Operates the equipment necessary to perform the job.
• Exposed to a normal office environment.

Preferred Qualifications

• Second Specialty credential preferred.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.