Following ICD-10-CM and CPT/HCPCS coding principles and procedures, Data Integrity Analyst will identify all CMS, NCCI 3M generated edits, on previously coded accounts, via CHRISTUS Health systems, to verify the applicability and accuracy of said edits. During the review process, Data Integrity Analysts will resolve edits by applying applicable CPT/HCPCS modifiers based on CMS approved guidelines, while maintaining activity logs and data files for quality review and statistical analysis.
Data Integrity Analyst will work to increase Coder productivity, decrease the number of Late/Ignored edits, increase the timeliness of bills and payer reimbursement and decrease the amount of edit based denials.
Data Integrity Analyst will be assigned a primary region and will report directly to the Specialty Coding Manager.
Analyze previously coded accounts for NCCI and CMS edits generated in the 3M encoder.
Verify applicability and appropriateness of edits while making corrections by adding, changing, and/or removing modifiers.
Validate charges are correct; if there are charging discrepancies, based upon CPT guidelines and best practices, communicate with the appropriate charging department to make corrections.
Identify accounts requiring secondary review by coding associates for corrections.
Consistently and accurately document account findings for tracking and trending purposes.
Review and provide corrections for account reviewed both internally and externally.
Perform other duties as assigned.
High School Diploma or G.E.D. equivalent is required. College course work in Accounting, Business, or Health Care Administration, preferred.
Completion of an AHIMA approved Coding Certificate Program, preferred.
Strong written and verbal communication skills.
Able to work independently in a remote setting, with little supervision.
Two(2) years of medical record, hospital billing/charging, hospital coding, peffered.
Registered Health Information Administrator (RHIA) (AHIMA)
Registered Health Information Technician (RHIT) (AHIMA)
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.