PRIMARY JOB RESPONSIBILITIES
Serve as an organization resource and content expert for current documentation and coding guidelines.
Provide education and training on the results of internal audits and partner with Compliance on external audit education
Provide expert coding content knowledge to UW Medicine staff and other key stakeholders.
In conjunction with the Director, develop and deliver role-specific training for ERHI Coding staff, develop and implement effective monitoring, auditing and risk assessment activities.
Monitor developments in related rules, regulations and coding changes; make recommendations to the Assistant Director, as needed, to maintain coding compliance/quality and mitigate risk.
Coordinate with and provide guidance to Compliance, Clinical Documentation Improvement, Utilization Management, Clinical Resource Management and Patient Financial Services on matters involving coding/billing compliance content related issues.
Perform coding audits, analyze results and create audit reports.
Review DRG and CPT claim denials for commercial payers.
Maintain written documentation of actions, activities or assessments (e.g., investigations, patient rights, audits, process improvement projects, corrective action plans, education and training plans) in accordance with state and federal law, and institutional policies. Retains records in accordance with the UW Retention Schedule and department policy.
Evaluate billing/coding/documentation behavior and identify recommendations for improvement. Provide consultation and best practice guidance to engage and influence outcomes.
Review, analyze and determine effectiveness of training, assess effectiveness against entity/workforce member type/and industry KPI’s (key performance indicators), and recommend enhancements to training content and user experience.
Manage or conduct audits, and ensure they are performed in accordance with the UW Medicine Audit Policy.
As a member of the Coding Analyst team, may perform any work that is necessary to complete department activities and meet established deadlines.