Coding Quality Specialist

Posted Yesterday
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Hiring Remotely in NJ, USA
Remote
Senior level
Healthtech • Professional Services
The Role
Perform coding audits and validation reviews to ensure compliance with federal and state regulations (Medicare/Medicaid). Review PSIs, POA, CDI, quality and performance improvement items. Provide coding education/feedback and apply CPT, ICD-CM, E/M guidelines, CCI edits, Medicare LCDs/NCDs, and DRG knowledge.
Summary Generated by Built In

Perform coding audits to determine that all coding remains compliant and meets all federal and state guidelines (i.e. Medicare/ Medicaid). Perform coding validation reviews for Patient Safety Indicators (PSIs), Present on Admission (POA), Compliance, Clinical Documentation Improvement, Quality and Performance Improvement. Assist with internal/external coding education/feedback. Must have experience working with CPT, ICD-CM diagnosis and procedure coding, E/M Documentation Guidelines, CCI edits, Medicare LCDs and NCDs, state and federal regulations. Knowledge of DRGs required.

Qualifications
Bachelor's degree or Associate's Degree with 5 years of coding and/or coding auditing experience..

Five to seven years of work experience. Registered Health Information Administrator (RHIA) and/or Certified Coding Specialist (CCS) by American Health Information Management Association or Certified Professional Coder (CPC) through American Academy of Professional Coders (AAPC).

About Us

St. Joseph’s Health is recognized for the expertise and compassion of its highly skilled and responsive staff. The combined efforts of the organization’s outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation’s “100 Best Places to Work in Health Care”.

Benefits Eligibility: (Full-time and Part-time Employees-over 20 hours a week)

  • Competitive salary*
  • Robust benefits with health, dental, Rx and vision plans
  • 403b retirement plan options with company match**
  • Health & Wellness*
  • Non-Profit Health System – eligible for Federal Student Loan Forgiveness
  • PTO, and paid holidays
  • Tuition reimbursement
  • Employee Assistance Program
  • LTD : Long Term Disability
  • Life Insurance Options
  • Onsite Day care Program

*Available for Per Diem Employees and Part-time Employees working under 20 hours per week.

**403b Company Match not applicable for Per Diem Employees and Part-time Employees working under 20 hours per week.

Pay transparency:  St. Joseph’s Health provides a salary range to comply with New Jersey Law.  The rate of pay for each position will be determined based on a variety of factors including the candidate's relevant experience, qualifications, skills, etc.” The salary range does not include incentives, differential pay or other forms of compensation.

About the Team

St. Joseph’s University Medical Center is an academic tertiary care medical center and state designated trauma center, located on the Paterson campus, regularly accepts referrals of difficult or unusual cases from other hospitals and physicians and performs both complex and routine procedures. 

The Medical Center offers a full complement of specialty and subspecialty services including ambulatory, behavioral health, cardiovascular, emergency/trauma, internal medicine, neuroscience, oncology, orthopedic/spine, rehabilitation, surgical specialty, women’s health, imaging and pediatrics. 

The nursing team at St. Joseph’s University Medical Center, which includes St. Joseph’s Children’s Hospital, has held the Magnet Award for Nursing Excellence, the profession’s highest honor, since 1999. They are also recipients of the prestigious 2010 Magnet Prize™ - one of only 8 Magnet-designated hospitals to ever receive The Magnet Prize, and the only one worldwide to receive the 2010 award.

Skills Required

  • Bachelor's degree or Associate's Degree with 5 years of coding and/or coding auditing experience
  • Five to seven years of work experience
  • Registered Health Information Administrator (RHIA) and/or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)
  • Experience with CPT, ICD-CM diagnosis and procedure coding, E/M Documentation Guidelines, CCI edits, Medicare LCDs and NCDs, and state and federal regulations
  • Knowledge of DRGs
  • Experience performing coding audits and coding validation reviews for Patient Safety Indicators (PSIs), Present on Admission (POA), Compliance, Clinical Documentation Improvement (CDI), Quality and Performance Improvement
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The Company
5,292 Employees
Year Founded: 1867

What We Do

St. Joseph's Health is a non-profit health care system based in Syracuse, NY. Founded in 1869 as the first hospital open to the public in the city of Syracuse, it provides a comprehensive range of primary, specialty, and home care services. As a member of Trinity Health, it is recognized as a leading regional hospital and is dedicated to advancing the well-being of its community.

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