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On-site work will be required, with some remote work.
Scope of Position: The Senior Coding Education and Data Consultant ensures documentation and coding compliance at Ohio State University Wexner Medical Center. The Senior Coding Education and Data Consultant is responsible for conducting data analysis, generating and developing reports, auditing coding and medical record documentation, identifying improvement opportunities, and creating education plans for coders, CDIs, and providers. This role is expected to develop an action plan and influence adoption by effectively engaging coding, CDI, and providers.
The consultant evaluates performance to assess the quality of medical record documentation and coding, preparing recommendations based on the results. They monitor the case-mix index for services and hospital entities, Vizient and hospital-related quality initiatives (e.g., patient safety indicators, pressure ulcer monitoring, mortality reviews, etc.), and the Program for Evaluating Payment Patterns Electronic Report (PEPPER). These measures help identify opportunities for improvement and help ensure compliant coding. The consultant provides and presents detailed findings reports. The consultant will conduct in-depth reviews of billed codes, charges, and modifiers and report findings.
Moreover, the Senior Coding Education and Data Consultant serves as a subject matter expert on compliant documentation and coding opportunities. The Senior Coding Education and Data
Consultant will guide root cause analysis, measure coding and reimbursement opportunities and risks, and then communicate these findings to the Director of Coding and Compliance, as requested by the Administration.
Position Summary: This position conducts health-system-wide coding analyses to promote compliance with federal and state regulations pertaining to but not limited to ICD-10-CM, ICD- 10-PCS, and CPT-4 coding, assignment of modifiers, charge entry, and data abstraction for hospital billing and must understand the principles of physician documentation. Under the direction of the Director of Inpatient Coding and Compliance, the Senior Coding Education and Data Consultant assists in determining controls and monitors risk areas or changes to review risk management and ensure compliance with documentation and coding regulations. Consultant operates with extreme tact and diplomacy in performing job duties while interacting with faculty and staff from all areas of the Medical Center.
Minimum Qualifications
For hire or promotion:
- High School Diploma or GED required.
- CAHIIM approved coding certificate program or HIMT program
- Associate degree in relevant field, preferred.
- Accredited as a Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Documentation Improvement Professional (CDIP) by the American Health Information Management Association, or Certified Clinical Documentation Specialist (CCDS) by ACDIS
AND
Two to six years of experience in inpatient hospital coding and clinical documentation improvement is preferred. Experience with electronic medical record systems and encoders is required. Knowledge of ICD-10-CM, ICD-10- PCS, CPT-4, Official Coding Guidelines, and Medicare Billing Rules is required.
Ability to communicate and demonstrate interpersonal skills required. Demonstrated ability to lead others either formally or informally.