Physician Coding Quality Analyst

Company: Stanford University
Location: Redwood City
Posted on: June 12, 2021

Job Description:

The Department of Pediatrics in the School of Medicine is seeking a Physician Coding Quality Analyst to join the Clinical Finance team to review physician documentation for the appropriate application of CPT/ICD10-CM coding guidelines. Will provide yearly coding updates, new provider training and other physician education as needed.

Duties include:

• Lead the planning and operations for programs or functions that have significant business, regulatory and/or technical challenges requiring subject matter expertise.
• Evaluate programs or functions, policies and procedures. Identify issues, and develop alternative solutions which may include changes to programs, policies and procedures.
• Review and analyze trends to advise and develop recommendations to achieve or modify the goals of the program or function.
• Represent the program or function within the department, unit or school. Commit resources and provide information and/or training. Represent the program or function at the university level and/or to external/internal stakeholders and constituencies.
• Manage and contribute to the development of outreach strategy that may include relationship development, communications and compliance
• Assess training needs and may develop associated training.
• Auditing and reviewing medical documentation for appropriate CPT coding and documentation
• Perform training and education to physicians regarding coding and documentation.
• Analyze trends and provide recommendations to leadership
• Perform audits of documentation & coding of inpatient and/or outpatient professional fee services;
• Work with LPCH Revenue Cycle leadership and division faculty to improve efficiency and timeliness of billing sheet submission.
• • Other duties may also be assigned

DESIRED QUALIFICATIONS:

• Ability to apply critical thinking skills to coding policy interpretation and implementation
• Work independently; well-organized and able to set priorities with minimal direction
• Effectively communicate both verbally and in writing
• Strong PC skills; Excel, Word, PowerPoint and internet based program

EDUCATION & EXPERIENCE (REQUIRED):

Bachelor's degree and five years of relevant experience, or combination of education and relevant experience.

Active CPC or CCS-P certification required. Additional CPMA certification a plus. Inpatient and Outpatient Evaluation and Management coding proficiency required.

KNOWLEDGE, SKILLS AND ABILITIES (REQUIRED):

• Demonstrated ability to establish priorities, manage shifting priorities, and handle numerous time-sensitive projects with multiple deadlines.
• Ability to accomplish goals working through formal and informal channels, with diplomacy and tactfulness.
• Demonstrated creativity, problem solving, critical analysis, initiative, judgment and, decision-making skills.
• Demonstrated ability to develop and meet department goals.
• Demonstrated solid planning and organizational skills.
• Demonstrated experience working independently and as part of a team.
• Excellent interpersonal, written and oral communication skills.
• Strong relevant subject matter knowledge.

CERTIFICATIONS & LICENSES:

Active CPC or CCS-P certification required. Additional CPMA certification a plus.

PHYSICAL REQUIREMENTS*:

• Constantly perform desk-based computer tasks.
• Frequently stand/walk, sitting, grasp lightly/fine manipulation.
• Occasionally use a telephone.
• Rarely lift/carry/push/pull objects that weigh 11-20 pounds.
• • Consistent with its obligations under the law, the University will provide reasonable accommodation to any employee with a disability who requires accommodation to perform the essential functions of his or her job.

WORKING CONDITIONS:

Additional Information

• Schedule: Full-time
• Employee Status: Regular
• Requisition ID: 89042

Keywords: Stanford University, Redwood City , Physician Coding Quality Analyst, Other , Redwood City, California