Coding Quality Analyst – Remote

Aurora Health Care


Aurora Health Care is a not-for-profit health care system headquartered in Milwaukee and serving eastern Wisconsin. The system has 15 hospitals, more than 150 clinics, and 70 pharmacies. With 32,000 employees, including 1,800 employed physicians, Aurora is Wisconsin’s largest home care organization.

This role will support our hospital based coding team. This is a REMOTE opportunity.

Primary Purpose:

Acts as a liaison between hospital coding operations, clinical documentation improvement, quality, compliance, decision support, business office, informatics, hospital departments and Administration. Serves as a resource regarding coding information in the hospital setting providing feedback and problem resolution.

Major Responsibilities:

Reviews encounter specific clinical documentation as appropriate to ensure appropriate coding for billing, internal and external reporting, quality, research and regulatory compliance.

Independently develops and maintains data analysis spreadsheets and reports. Identifies, analyzes, and interprets trends or patterns in complex datasets, denials and coding outcomes.

In collaboration with the coding quality team, implements data collection systems and other strategies that optimize statistical data collection to monitor and track overall coding quality and performance.

Identifies successes and opportunities in coding quality, tracks and creates reports for Coding leadership.  Identifies opportunities for education of staff and to mitigate future errors and denials. Tracks and creates trend data to identify and resolve any provider documentation concerns.

Provides feedback and education to providers as necessary regarding specificity of documentation, denials and regulatory requirements. Provides relevant topics and input for provider specific newsletters.

Collaborates with clinical documentation improvement (CDI), Quality and Administration in synthesizing data as it relates to benchmarking and outcomes

Researches, develops and creates educational materials surrounding all quality indicators with department-wide focus on performance improvement and quality management for the Coding team.

Facilitate improvement in provider documentation by identifying gaps and through interactions with physicians and other members of the healthcare team to ensure proper coding and reimbursement based on patient’s condition.

Licensure, Registration and/or Certification Required:

  • Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA), or
  • Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
  • Health Data Analyst (CHDA) certification issued by the American Health Information Management Association (AHIMA), or
  • Documentation Improvement Practitioner (CDIP) certification issued by the American Health Information Management Association (AHIMA).

Education Required:

  • Bachelor’s Degree in Health Care Administration or related field.

Knowledge, Skills & Abilities Required:

  • Demonstrates expert knowledge of ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, MS-DRGs and APCs; able to apply both national/internal coding guidelines in accurate code selection.
  • Knowledge in quality core measures and coding classification systems and Local and National Coverage Decisions.
  • Knowledge of clinical documentation improvement and its impact on reimbursement and quality.
  • Knowledge and understanding of anatomy and physiology, medical terminology, pathophysiology, diagnoses, procedures and pharmacology indications for drug usage and related adverse reactions.
  • Knowledge of coding work flow and optimization of technology.
  • Advanced computer skills in Microsoft office products; including but not limited to excel and powerpoint.
  • Experience in maintaining spreadsheets, reports and graphs.
  • Excellent communication (oral/written) and interpersonal skills. Ability to develop rapport and maintain positive relationships with patients, caregivers and providers.
  • Demonstrates a high level of professionalism; ability to function as a mentor and educator.
  • Excellent critical thinking/analytical skills and strong problem solving/decision-making skills with a high attention to detail.
  • Ability to meet deadlines in a fast-paced environment.

Education Qualifications:

Bachelor’s Degree in Health Care Administration or related field.

Apply Online:

Please apply on line to Aurora Health Care Career page