Integrity Analyst - PB Coding Quality Medical Specialties
Department:
10417 Enterprise Revenue Cycle - Integrity Operations: Professional Coding Quality Status:
Full time Benefits Eligible:
Yes Hou rs Per Week:
40 Schedule Details/Additional Information:
Desired Experience:
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Medical Specialty and/or Surgical coding experience
- E/M Level coding a must.
Schedule:
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Full-time remote, first shift, Monday - Friday.
Certification required:
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Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA).
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Second Specialty credential preferred – Specifically CPMC and CMC
Remote opportunity:
Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY
Pay Range:
$35.50 - $53.25 Major Responsibilities
Research, interpret, and apply coding, payer, and regulatory requirements to supportaccurateand compliant Professional and Hospital coding practices.
Develop,maintain, and update coding guidance, standard work, reference materials, and position statements to ensure enterprise consistency.
Coordinate and support coding quality audits by routing requests,maintainingrecords, and verifying documentation completeness and accuracy. Track audit findings, quality issues, and compliance risks, documentingpatternsand supporting corrective actions.
Analyze coding quality data and audit results toidentifytrends, risks, and opportunities for improvement.
Prepare summaries, reports, and materials for leadership, audit reviews, and quality improvement initiatives.
Partner with Integrity Operations, coding leadership, clinicians, and education teams to improve documentation quality and coding accuracy.
Support regulatory, compliance, and quality-related projects, ensuring adherence to organizational policies and AHIMA coding standards.
Respond to internal inquiries related to coding guidance, quality findings, and audit outcomes.
Support testing, reporting validation, and workflow updates related to coding quality, guidance, and compliance initiatives.
Minimum Job Requirements
Education
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Associate degree or equivalent education and experience required.
Certification / Registration / License
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Coding credentials required. Certification from American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) such as RHIA or RHIT or CCS, or CCS-P, or CPC.
Experience
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5 years of experience in expert-level professional coding or hospital-based coding and experience in revenue cycle processes, health information workflows, and medical record auditing experience.
Knowledge / Skills / Abilities
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Advanced knowledge of ICD, CPT, and HCPCS coding guidelines.
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Advanced knowledge of medical terminology, anatomy, and physiology.
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Advanced ability toidentifycoding quality issues/concerns and provide recommendations for improvement.
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Advanced ability to analyze trends and data and display them in a statistical reporting format.
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Advanced organization and communication (verbal and written) skills.
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Advanced ability to effectively train others through oral and/or written methods.
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Advanced organization, prioritization, and reading comprehension skills.
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Advanced analytical skills, with high attention to detail.
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Advanced knowledge of Microsoft Office, video and web conferencing, email, and experience with electronic coding and EHR systems or applications.
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Advanced knowledge of care delivery documentation systems and related medical record documents.
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Advanced interpersonal communication skills (oral and written) necessary to collaborate with Physicians, other clinicians, and Professional CodingDepartmentteam members and leadership.
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Ability to work independently an