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Coding Review Analyst

Category:  LRHC Technical
Department:  Health Information Management
Status:  Full-time
Schedule:  Days
Description: 

The purpose of this position is to research and analyze outpatient related claim edits, returns from providers, denials, internal edits, patient complaints, Patient Financial Services questions and concerns, as well as coding compliance software audit messages to optimize reimbursement for Lake Region Healthcare. Identifies edit and error related trends associated with this outpatient related work. Provides information on findings and trends to enterprise coding leaders as requested for use in coder education and other communications. Participates in the development of validation checks and other edits to provide real-time opportunities for outpatient coders to receive front-end alerts during the coding process, aiding in revenue cycle enhancements. Provides feedback and direction on coding related software edits, denial issues, reimbursement staff, and organizational departments such as Patient Financial Services, Compliance, and clinical departments.

Requires certification in RHIA, RHIT, CCS, CCS-P, CPC or CPC-H upon hire or must obtain within one year of the date of hire. Must have extensive knowledge of diagnostic and procedural terminology, ICD-9, ICD-10, CPT-4 and HCPCS coding schemes usually acquired through certification. Prefer two years experience in hospital outpatient coding. Must have working knowledge of anatomy, physiology, and pathophysiology to understand disease processes, treatment or management of medical and surgical conditions. Must have current knowledge in coding schemes and prospective payment systems and clinical practices and technology. Must have computer skills and knowledge of information systems. Must be able to effectively train others to achieve maximum accuracy. Must also possess knowledge of state and federal laws, rules and regulations. Ability to effectively interact with others and strong customer service related skills.

Printable application available online

Or

The Human Resources Department at
Lake Region Healthcare
712 Cascade St. S. • Fergus Falls, MN 56537

(218)736-8469

EEO/AA/Drug Testing Required/Tobacco Free Campus


Posted:  10/29/14

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