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Company Name:
Approximate Salary:
Not Specified
California Greater Sacramento Area Roseville, California
United States
Position type:
Full Time
Experience level:
Education level:
2200 River Plaza Drive
Job Title:
Coding Quality Assurance Specialist - Shared Services/Remote
(916) 733-8800

Coding Quality Assurance Specialist - Shared Services/Remote

Performs quality reviews of Coding staff work activities to ensure compliance with Coding guidelines and policies. Analyzes findings from quality reviews of coding staff, and other relevant coding data, in order to provide feedback and support for training and clinical documentation improvement efforts. Provides audit results to Coding Team leads and shared recommendations for course-correction and education as needed.

Supports the success of a high-performing shared services organization by helping to champion and drive the long-term Sutter Shared Services vision. Helps foster an environment in which continuous improvement in business processes and services is welcomed and recognized. Participates in programs and in using tools in support of building a high performance culture via the standard Sutter Shared Services responsibilities (e.g. performance measurement, people development, customer relationship management, etc.).

• BA/BS degree or equivalent combination of education and experience desired.

• Registered Health Information Technician, Registered Health Information Administrator, and/or Certified Coding Specialist required.

• Certified Clinical Documentation Specialist desired.

• Demonstrated experience and a proven track record in coding, training, and/or service development in a facility of significant size and complexity, hospital business operations, information systems, and coding applications, as typically acquired in 3-5 years of experience
• Demonstrated experience in the fundamentals of auditing and monitoring
• Experience executing Coding Quality Assurance standards, processes, policies, procedures and service level agreements
• Experience in complex regional/ shared service environment with multiple/ matrix reporting relationships preferred
• Experience participating in planning new or expanded services and managing projects

• In-depth knowledge of Diagnosis Related Groups, Ambulatory Payment Classifications, ICD-9-CDM, and Current Procedural Terminology Coding systems and related coding issues including charge capture and evaluation and management leveling
• In-depth knowledge and understanding of coding compliance and quality assurance
• Familiarity with medical terminology and the medical record coding process
• Strong working knowledge of anatomy, physiology and pharmacology
• General knowledge of Revenue Cycle applications, including Electronic Health Record systems
• General knowledge/ awareness of all areas related to Coding and how they interrelate
• General knowledge of how to conduct a quality control audit
• Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections
• Familiarity with Coding management functions in acute and non-acute settings
• Knowledge of Patient Management information system applications, preferably EPIC

• Ability to quality check other’s work and compile audit reports based on findings
• Ability to provide coaching and feedback to Coders if quality assurance results are subpar
• Ability to train staff and resolve issues in a virtual environment
• Ability to work closely with medical staff and other departments to create a complete and accurate database of clinical and demographic data while ensuring appropriate coding
• Ability to run reports needed to improve patient care
• Ability to comprehend and retain information that can be applied to work procedures to achieve appropriate service delivery
• Requires strong accuracy, attentiveness to detail and time management skills for translating complex medical documentation into diagnostic classification system codes
• Aptitude to conceptualize, plan, and implement stated goals and objectives
• Ability to manage own schedule and responsibilities. Must have initiative to work effectively without constant supervision and direction, meeting all deadlines
• Ability to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles.
• High-level problem identification/ mitigation/ resolution and analytical skills
• Ability to develop effective working relationships/ networks within and outside the organization
• Excellent ability to communicate ideas both verbally and in writing to influence others using on-on-one contact, formal presentations, and group discussions
• Ability to recognize the appropriate style, level of detail, and message for the audience
• Computer keyboarding skills and experience with computerized coding/abstracting systems and encoders Ability to use spreadsheet, word processing, statistical, project management, and presentation software applications, preferably Microsoft Suite
• Ability to learn new applications/software systems effectively and efficiently
• Ability to comply with Sutter Health policies and procedures
• Requires the ability to work with and maintain confidential information

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