Uncommon Life | St. Joseph, MO

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Remote - HIM QA Coding Analyst

Mosaic Life Care

Mosaic Life Care

IT, Quality Assurance
Posted on Tuesday, March 26, 2024

Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care.

Mosaic has a wide array of benefits to meet each employee’s individual needs. Our benefits were designed by listening to people just like you. Mosaic also offers several perks with a focus on ensuring our employees feel valued, including concierge services, employee lounge, wellness programs, free covered parking, free on-site and virtual health clinics and many more. When paired with compensation and recognition, it is what continues to make us the employer of choice for employees at any stage of their journey.

  • Remote - HIM QA Coding Analyst
  • Health Information Management
  • Full Time Status
  • Day Shift
  • Pay: $56742.40 - $85113.60 / year
  • Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Tennessee, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time.
  • This position possesses fair and unbiased judgement while performing both random and targeted audits to identifying high risk areas for the organization as directed by the HIM Data Quality Manager in the following areas: professional, facility, clinic, external vendor, coder, system, and denial. This position in collaboration with other HIM Managers will be responsible for creating, reviewing, and updating department processes, guidelines, and standards in adherence to regulatory changes and organizational compliance laws and regulations. This position will also be responsible for identifying, creating, and providing individual or group education for clinical staff, providers, and coders. This position should have exceptional communication skills in both verbal and written form. They will serve as a liaison with Knowledge Management, Health Information Management, Patient Financial Services, Revenue Integrity, clinical staff and provider relations. This position must have good problem solving and researching skills and be able to interpret CMS regulations and guidance. This position will also assist leadership in identifying, creating, and monitoring process improvements to ensure compliance with organizational policies, procedures, laws, and regulations.
  • This position works under the guidance and supervision of the HIM Data Quality Manager and is employed by Mosaic Health System.
  • Reviews a wide variety of HIM policies and procedures to ensure compliance with legal, accreditation, and internal standards. Analyzes existing policies, identifies gaps, and recommends new/revised standards and monitoring methods for departmental use. Reviews detailed departmental processes and policies noting deficiencies.
  • Researches and develops materials for educational programs related to all aspects of coding and documentation.
  • Designs and implements risk assessments to analyze processes for coding and documentation to identify areas for improvement. Prioritizes risk assessments based on level of the organizational exposure.
  • Investigates and responds to audits identified by the Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Zone Program Integrity Contractor (Z-PIC), and/or Medicaid Integrity Contractor (MIC) in collaboration with Health Information Management, Patient Financial Services, Knowledge Management, Chart Audit, Revenue Integrity and/or Care Management. Audits potential issues before they are identified by the regulatory auditors. Coordinates with HIM managers in regard to DRG changes and other audits.
  • Designs and implements audits throughout the organization. Verifies compliance/noncompliance issues against established policies, procedures, applicable laws, and regulations. Facilitates the resolution of noncompliant findings and escalates possible critical issues to QA Manager. Audits may focus on, but are not limited to, documentation, billing, coding, medical necessity, systems, and reimbursement. Analyzes results of assessments for presentation to clinic leadership, providers, compliance, and/or leadership.
  • Associates degree in a healthcare-related discipline preferred.
  • CPC, CCS, COC, RHIT, or RHIA required
  • Minimum of 5 years coding/billing experience preferred in health care industry, with specific experience typically obtained as a coder, consultant, and/or auditor. Prior experience performing coding audits or experience working with providers and caregivers to correct coding and documentation issues with demonstrated success is a plus.