Coding Quality Analyst

Northern Light Health, in strategic partnership with Optum, is hiring a Coding Quality Analyst. The role supports accurate coding and documentation through provider and coder education, audits, trend analysis, and coding guidance.

Responsibilities

• Serve as a liaison between coding teams and providers, delivering expert guidance to resolve inquiries and concerns
• Collaborate with Edits and Denials teams to analyze trends and implement educational initiatives or system edits to address recurring issues
• Partner with clinical leadership during the introduction of new services to ensure accurate documentation and coding compliance
• Participate in specialty and physician group meetings on a quarterly basis to provide targeted coding education and respond to ad hoc inquiries
• Deliver comprehensive coding and documentation training for all newly onboard providers
• Provide annual education to providers with on code set updates to maintain compliance and accuracy
• Conduct annual provider audits to validate charges and support documentation, while identifying potential revenue opportunities
• Provide targeted education and follow-up audits for providers who do not meet established quality standards
• Perform ad hoc audits in response to client requests or identified concerns
• Educate coders and providers on audit findings and emerging trends to promote continuous improvement
• Assist coders and/or supervisors as needed on rebuttals for tri-annual audits

Preferred

• Experience auditing charts in a professional coding environment
• Experience providing physician/coding education a plus
• Experience with various systems (Microsoft Teams, Encoder Pro, etc.)
• Experience in Inpatient/Observation E/M coding
• Intermediate level of experience with Microsoft Excel
• Chart Auditing
• Physician Education
• Coding Education
• Microsoft Teams
• Encoder Pro
• Inpatient E/M Coding
• Observation E/M Coding
• Microsoft Excel (Intermediate)

Benefits

• Flexible telecommuting from anywhere within the U.S.
• A comprehensive benefits package (subject to eligibility requirements)
• Incentive and recognition programs (subject to eligibility requirements)
• Equity stock purchase (subject to eligibility requirements)
• 401k contribution (subject to eligibility requirements)

Company

• Health care services and prescription management
• Eden Prairie, Minnesota, USA
• https://nm.optum.com/
• Founded in 1985
• 10001+ employees

Qualifications

• High School Diploma/GED
• Professional coder certification with credentialing from AHIMA and/or AAPC (CPC, CCS-P, RHIA, RHIT) to be maintained annually
• 3+ years of Physician medical coding (ICD-10, CPT, HCPCS II) experience in a multi-specialty physician clinic
• 2+ years of experience with Residency Program (teaching hospital) with surgical coding experience in Evaluation and Management plus one or more of the following: Orthopedics, Gastroenterology, General Surgery, Urology, Otorhinolaryngology, Cardiology, Pulmonary Medicine, Womens Health, Podiatry, Neurosurgery, Primary Care, Cardiothoracic, Vascular, Physiatry, Neurology, Ophthalmology, Pain Management, Plastic and Reconstructive Surgery, Wound Care, Radiology, Breast Surgery, Psychiatry, Oral and Maxillofacial Surgery, Oncology, Dermatology, Rheumatology, Optometry
• 2+ years of experience being able to provide expert level coding guidance to physicians, practitioners, and coders as needed
• Intermediate level of knowledge of MUE and NCCI classification and reimbursement structures
• Intermediate level of proficiency in a Windows PC environment, including MS Excel and with Epic
• Must be able to communicate effectively face-to-face and in writing
• Experience auditing charts in a professional coding environment
• Experience providing physician/coding education a plus
• Experience with various systems (Microsoft Teams, Encoder Pro, etc.)
• Experience in Inpatient/Observation E/M coding
• Intermediate level of experience with Microsoft Excel

Required skills

• CPT, Coding Auditing, Epic, Evaluation and Management (E/M) Coding, HCPCS Level II, ICD-10, MUE, NCCI, Professional Medical Coding, Surgical Coding

Preferred skills

• Experience in Inpatient/Observation E/M coding, Experience providing physician/coding education a plus, Intermediate level of experience with Microsoft Excel

Experience

• 3+ years