Hospital Coding Quality Specialist - REMOTE
Advocate Health Care
- Illinois Wisconsin
- Permanent
- Full-time
- Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA), or
- Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
- Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA)
- Associate's Degree in Health Information Management or Associate's Degree in related field.
- Typically requires 5 years of experience in hospital coding for a large complex health care system, which includes hospital coding, denial review and/or coding quality review functions.
- Demonstrated leadership skills and abilities.
- Demonstrates knowledge of National Council on Compensation Insurance, Inc. (NCCI) edits, and local and national coverage decisions.
- Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups).
- Advanced knowledge in Microsoft Applications, including but not limited to; Excel, Word, PowerPoint, Teams.
- Advanced knowledge and understanding of anatomy and physiology, medical terminology, pathophysiology (disease process, surgical terminology and pharmacology.)
- Advanced knowledge of pharmacology indications for drug usage and related adverse reactions.
- Expert knowledge of coding work flow and optimization of technology including how to navigate in the electronic health information record and in health information management and billing systems.
- Excellent communication and reading comprehension skills.
- Demonstrated analytical aptitude, with a high attention to detail and accuracy.
- Ability to take initiative and work collaboratively with others.
- Experience with remote work force operations required.
- Strong sense of ethics.