This is a remote role
Position Summary
The Coding Services Quality Analyst ensures the accuracy, compliance, and quality of medical coding and documentation within healthcare records. This role is essential in maintaining regulatory standards, supporting accurate coding processes, and minimizing compliance risks. The Quality Analyst collaborates with the Coding Services Manager and Director. The Quality Analyst will provide feedback and necessary training as needed.
- Quality Assurance and Auditing
- Perform regular audits of coded medical records to ensure compliance with ICD-10, CPT, and HCPCS standards.
- Identify and correct coding errors to optimize coding accuracy and minimize denials.
- Evaluate documentation to confirm it supports the assigned codes.
- Compliance Monitoring
- Monitor coding practices for adherence to federal and state regulations, including HIPAA, CMS guidelines, and other applicable standards.
- Support the organization in maintaining compliance with internal policies and external audits.
- Data Analysis and Reporting
- Compile audit results and prepare detailed reports to identify trends, gaps, and areas for improvement.
- Track quality metrics and provide recommendations for process enhancements.
- Education and Training
- Provide feedback and training to medical coders on identified errors and best practices.
- Assist in the development and delivery of educational materials on coding updates and guidelines.
- Collaboration
- Work closely with Coding Services Manager and Coding Services Director.
- Education: Associate's or Bachelor's degree in Health Information Management, or a related field (preferred).
- Certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required.
- Experience:
- Minimum 5 years of experience in medical coding.
- Minimum 5 years of experience auditing coded records.
- Minimum 3 years of experience mentoring staff.
- Familiarity with various EHR systems and coding software.
- Knowledge: Strong understanding of medical terminology, anatomy, and coding guidelines (ICD-10, CPT, HCPCS).
- Attention to detail and analytical thinking.
- Proficiency in auditing and quality assurance practices.
- Strong communication and interpersonal skills to provide constructive feedback.
- Ability to manage time and prioritize tasks effectively.
- Proficiency in Windows, Excel, Word, PowerPoint
- Strong ability to troubleshoot
- Experience working with diverse teams and a global workforce.
- Work Environment
- This position may involve remote, hybrid, or in-office work depending on organizational needs. Regular access to secure systems for coding review is required.
What We Offer:
AAPC offers a competitive compensation commensurate with experience, along with a comprehensive benefits package including medical, dental and vision insurance, 401(k) retirement plan, Health Savings Account (HSA), and generous PTO and holiday pay.
AAPC is an Equal Opportunity Employer. This company does not and will not discriminate in employment and personnel practices on the basis of race, sex, age, handicap, religion, national origin or any other basis prohibited by applicable law. Hiring, transferring and promotion practices are performed without regard to the above listed items.
Skills Required
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification
- Minimum 5 years of experience in medical coding
- Minimum 5 years of experience auditing coded records
- Minimum 3 years of experience mentoring staff
- Familiarity with various EHR systems and coding software
- Strong understanding of medical terminology, anatomy, and coding guidelines (ICD-10, CPT, HCPCS)
- Proficiency in Windows, Microsoft Excel, Word, and PowerPoint
- Proficiency in auditing and quality assurance practices
- Strong communication and interpersonal skills to provide constructive feedback
What We Do
AAPC was founded in 1988 to provide education and professional certification to physician-based medical coders and to elevate the standards of medical coding by providing student training, certification, ongoing education, networking, and job opportunities. Since then, AAPC has expanded beyond coding to include training and credentials in documentation and coding audits, regulatory compliance, and physician practice management. AAPC's membership includes over 200,000 healthcare professionals worldwide, of which more than 100,000 are certified. AAPC has the largest network of billing, coding, auditing, and practice management professionals. We provide a suite of software and services that support healthcare organizations with training, accreditation, and the tools necessary to ensure revenue optimization. Learn more at this link: https://www.aapc.com/business/auditing-and-coding-services.aspx AAPC certifications encompass the entire business side of provider care, with physician coding (CPC®), hospital outpatient facility (COC®), hospital inpatient facility (CIC®), risk adjustment coding (CRC®), payer perspective coding (CPC-P®), practice management (CPPM™), and more. All certifications demonstrate a hands-on, working knowledge to support cleaner claim submissions, faster reimbursement, fewer denials, and better run practices. Specialty coding credentials are currently offered in 20 different fields of expertise. AAPC offers continuing education for all credentials through local chapters, workshops, webinars, a monthly newsmagazine (Healthcare Business Monthly), other publications, and conferences.
