Coding Analyst Job Description
Coding analyst
provides audit services including ICD-10-CM/PCS Coding, CPT-4 coding, abstracting, and DRG and APC reviews in all health care settings.
Coding Analyst Duties & Responsibilities
To write an effective coding analyst job description, begin by listing detailed duties, responsibilities and expectations. We have included coding analyst job description templates that you can modify and use.
Sample responsibilities for this position include:
Utilizing the most up to date documentation/guidelines in responding to appeals
Customizing and/or creating appeal letters in a professional manner
Handling appeals and/or telephone/email inquiries related to determination of appeal
Validating edits for non-editing client claims
Researching manuals (including but not limited to AMA, CMS, and PHX Clinical Manual) once an appeal is received by PHX
Utilizing the most up to date documentation/guidelines in responding to appeals and advising appropriate personnel of important changes / issues
Handling of "In-Process" claims / report as it relates to the editing and/or other departments to include, but not limited to, review of claim and/or medical records and applying appropriate edits
Mentoring and training Junior/ Coding Analysts
Research manuals/guidelines once an appeal is received
Utilize the most up-to-date documentation/guidelines in responding to appeals
Coding Analyst Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Coding Analyst
List any licenses or certifications required by the position: CPC, AAPC, CCS, AHIMA, RHIT, ICD, AMA, CANPC, RHIA, CRCS
Education for Coding Analyst
Typically a job would require a certain level of education.
Employers hiring for the coding analyst job most commonly would prefer for their future employee to have a relevant degree such as Associate and Bachelor's Degree in Healthcare, Education, Business, Health, Health Information Management, Medical Billing, Health Insurance, Health Care Programs, Health Care, Healthcare Management
Skills for Coding Analyst
Desired skills for coding analyst include:
Medical terminology
Anatomy
Physiology
Pathophysiology
Medications and ancillary test results on diagnoses assigned
Relationship of disease management
ICD10 and CPT and related coding/abstracting rules and guidelines
CPT-4
ICD-9 / ICD-10 CM guidelines and coding
ICD-10-CM and HCPCS
Desired experience for coding analyst includes:
Customize and/or create appeal letters in a professional manner
Handle appeals and/or telephone/email inquiries related to determination of appeal
Mentor and/or assist with Junior/Coding Analysts
Handle appeals and/or telephone/email inquiries related to determination of appeals
Maintain awareness of and ensure adherence to standards regarding privacy
Adheres to Florida Hospital Core Values
Coding Analyst Examples
1
Coding Analyst Job Description
Job Description Example
Our company is looking for a coding analyst. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for coding analyst
- Requires maintenance of confidential information encountered in every task associated with this job
- Requires compliance with department Coding Policy and Procedure manual and Coding Clinic guidelines, , any governmental coding regulations
- Requires coding knowledge of all specialties for multi-hospital coding
- Reviews and/or verifies diagnostic information as entered into JA Thomas by the CDIS (Clinical Documentation Improvement Specialists)
- Monitors the status of the unbilled reports, and resolves work items timely to help manage the timely filing of unbilled accounts
- Works closely with the CDIS (Clinical Documentation Improvement Specialists) for clear, complete documentation for all Medicare records entered into JA Thomas software
- Must possess in-depth knowledge of ICD-9-CM coding classifications, billing requirements
- Must be knowledgeable of encoding software
- Ability to work independently and collaborative with members of the health care team
- Able to demonstrate effective interpersonal and communication skills to promote cooperation from health care team, providers, payers, patients and their families
Qualifications for coding analyst
- Demonstrates proficiency with Optum encoder, CAC (computer assisted coder) and grouper applications
- Able to demonstrate intrapersonal skills and to communicate effectively
- An Associate’s degree in Medical Record Technology/Health Information field or completion of a coding certificate program from an AHIMA or CAHIIM accredited school
- Will consider candidates with inpatient coding experience in lieu of requirements if candidate can demonstrate coding proficiency by scoring a 75% or higher on an inpatient coding test
- Inpatient acute care hospital coding experience
- Bachelor’s degree in a Health Information Management field preferred
2
Coding Analyst Job Description
Job Description Example
Our growing company is hiring for a coding analyst. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for coding analyst
- Registered Health Information Management Administrator (RHIA), Registered Health Information Management Technician (RHIT), and/or Certified Coding Specialist (CCS)
- Must obtain within 2 years of hire
- Conducts research, develops statistical analysis and interprets the results of the analysis
- Working with Leaders to improve current team processes
- Project related responsibilities would include working with Leaders and Educators formatting coding skills assessments, preparing necessary documentation, developing a project plan, defining the test plan, and implementing end results
- Perform quality assurance testing on related database/documents with the ability to develop test scenarios
- Responsible for analyzing, compiling, and validating crucial medical data
- The data will be used to understand the current trends that may have an impact that will allow leaders to make well-informed decisions
- Responsible for developing varies reports that contains reliable information for upper-level management
- Creates formats that accurately and reliably categorize and capture relevant information derived from CMS coding and reimbursement updates and directives
Qualifications for coding analyst
- Minimum qualifications Post graduate in Finance/Commerce
- Minimum experience 2+ years of Guidelines, 5+ year of In depth reference data
- Detail Orientation – Function is critical from impact perspective
- Communication (Spoken – Assertiveness & Written) – Need to communicate with Front office (Portfolio managers) on need basis to ensure they understand client guideline breaches and act on correcting the trades
- Researches and documents updates to existing CMS promulgated code sets, and grouping methodologies
- Researches and documents forthcoming future initiatives from CMS and ensures that all areas with a need to know are apprised so that roadmaps can be appropriately updated and reprioritized as necessary
3
Coding Analyst Job Description
Job Description Example
Our growing company is looking for a coding analyst. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for coding analyst
- Facilitate and track new coder audits
- Analyzes reimbursement trends and issues using appropriate reporting tools and take immediate and necessary action to resolve
- Monitors and detect abnormalities in daily and monthly reimbursement at a company level
- Defines scenarios contributing to positive and negative PPA variance, address root causes and implement proactive measures to manage risk and to identify opportunity
- Effectively communicate analysis results and required actions, in both verbal and written forms
- Analyze change rates/patterns (engine vs
- Builds effective working relationships with key provider contacts
- Facilitates meetings and conference calls as needed with contacts to help in resolving issues
- This position will be required to make recommendations to management and may initiate implementation of new procedures and processes
- Audits and reviews medical documentation for appropriate ICD-9 and CPT coding and documentation
Qualifications for coding analyst
- Health care delivery network or provider group that relies on such knowledge to remain an ongoing concern
- Insurance concepts and reimbursement methodologies especially as it pertains to CMS directives
- Familiarity with ICD-10, CPT and HCPCS codes groupers such as the MS DRG’s
- Broad understanding of the current health care environment (commercial, Medicare, Medicaid)
- Excellent scientific writing skill
- Experience in both established benefit coding environments experience in determination of coding requirements for new benefits preferred
4
Coding Analyst Job Description
Job Description Example
Our innovative and growing company is hiring for a coding analyst. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for coding analyst
- Trains and educates others on coding, documentation, claim payment guidelines, and related issues
- Reviews CPT and ICD-9 codes annually for accuracy and implements changes
- Assists physicians and providers with questions and problems related to coding, documentation and billing
- Encourages teamwork
- Codes all the diagnosis, treatments and procedures for outpatient records in accordance to departmental policies and procedures
- Abstracts all OBS, outpatient surgery and procedure charts Verifies CAC codes and/or assigns diagnosis and procedure codes following ICD-9 coding principles, CPT Assistant, Coding Clinic guidelines and Department coding policies and procedures manual
- Assist physicians and other clinicians with questions regarding coding, and prospective payment requirements and guidelines
- Monitors the status of the unbilled reports, and correct errors to ensure the coding process is completed on a timely manner
- Assumes responsibility to maintain knowledge and compliance with all current hospital and departmental policies
- Reviews the encounter for proper admission source, discharge disposition, and assigns the operative physician and date of procedure to the chart-coding screen
Qualifications for coding analyst
- Required 2+ years of experience in claims processing and/or testing, with strong analytics, preferably in a healthcare environment
- Must be local to the Farmington, CT area – or within reasonable driving distance
- University or college degree in life science, chemistry, pharmacy, nursing, or equivalent relevant degree
- Demonstrated ability to adapt to different coding technologies
- Strong verbal and written communication skills, including ability to author Coding conventions, SOPs/WPs, and training materials
- Good problem-solving, negotiation and conflict resolution skills
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Coding Analyst Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of coding analyst. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for coding analyst
- Places all consultations into the abstract
- Knowledge of all specific outpatient patient types (Emergency room, ancillaries, surgeries and observations) and ability to code
- Must be able to score a minimum of 75% on a SDS/OBS coding test, given during interview process
- High school diploma and completion of a coding program from an AHIMA or CAHIIM certified school
- Will consider experienced applicant in lieu of requirements if applicant demonstrates a 75% or higher on a coding proficiency test
- Surgery and Observation acute care hospital experience is required (preferred)
- An Associate or Bachelor’s Degree in Medical Record Technology/Health Information Management or completion of a Coding certificate program from an AHIMA or CAHIIM accredited school
- 2-5 years Surgery and OBS coding
- RHIA, RHIT with CCS
- Must obtain within two years of hire
Qualifications for coding analyst
- Understanding of clinical trials methodology, GCP, system validation requirements, and coding tools
- Coding Certification ( CPC, CCS, or RHIT
- One to two years coding related experience and/or training
- Excellent computer kkills, Excel, Word, Outlook
- Clinical and/or coding review experience
- Healthcare and fraud experience required