Perform accurate and timely quality reviews of internal and vendor coding team members using appropriate code sets and coding guidelines.
Develop and perform timely coding education to internal and vendor coding team members on coding systems, coding standards, protocols and Carle coding workflow as required based on quality review outcomes.
Perform as a production coder when needed in a manner aligned with current coding productivity and quality standards.
Share results of quality reviews to HIM Leadership with recommendations for education and training.
Compile and track statistics related to the review function, completed quality reviews, and follow up from those reviews.
Identify coder training needs, system issues, and/or documentation issues and report them timely to HIM leadership.
Review and respond to coding denials and coding questions as requested or assigned and perform clinical validation of appeal letters as needed.
Participate in system and new application testing as needed.
Provide denial trending data to leadership as requested.
Develop and perform HIM coding team member group education on coding topics identified during quality reviews and denial reviews.

HIM Cert Coder, Quality Review Analyst

Key skills