Coding Analyst Education Specialist

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

The Coding Analyst & Education Specialist position champions coding accuracy and integrity across our facilities and provider teams. This role involves developing and delivering advanced, impactful coding and billing training, and crafting robust educational resources. The Specialist will be the go-to authority for all coding updates, regulatory changes, and complex payer requirements. Through methodical analysis of denial and edit trends and performance data, they will identify and address educational needs, thereby preventing denials, enhancing revenue, and ensuring consistent compliance. A crucial element of this role is regular hands-on coding, ensuring this position maintains direct, practical expertise. Furthermore, the Specialist will engage directly with providers through essential in-person, one-on-one meetings at their clinics, addressing everything from new clinician onboarding to post-audit education and specific support as needed.

This is a hybrid remote position. While the primary work location is home-based (remote), candidates must reside within Prescott, AZ (or surrounding area: Prescott Valley, Dewey, Paulden, Chino Valley) to accommodate required local travel to various clinics for in-person training and collaborative sessions. Please note there is no dedicated on-site office space available at the hospitals.

Complies with all relevant laws, rules, regulations, and ethical guidelines, including those set by AAPC, AHIMA, NCCI, CMS, and the Standards of Coding Ethics.
Reports any suspected violations of the law to immediate supervisor, compliance officer, or CEO.
Maintains patient, medical record, department, and employee confidentiality at all times.

Accurate Coding and Data Integrity:
Accurately assigns and sequences CPT, Modifier, ICD, and HCPCS codes for encounters from assigned work queues, optimizing reimbursement in conformance with policies and ensuring all data has been considered for compliant coding and charging.
Codes only diagnoses and procedures substantiated by documentation, following coding guidelines, and distinguishing cases requiring clarification from physicians through direct contact or query forms.
Verifies charges against documentation where defined by policy, routing discrepancies to the appropriate department.

Utilizes coding applications and systems to accurately code, abstract, and analyze APCs and modifier assignments.
Maintains high-quality statistical clinical data and strives for optimal, legally entitled payment, without misrepresenting codes or including/excluding based on payment effects.
Ensures correct demographic information is present on each claim to facilitate clean claim submission.

Serves as a subject matter expert, interacting daily with providers, Practice Managers, Revenue Cycle staff, and HIM department staff to facilitate communication and address coding/documentation needs.
Develops and implements comprehensive training and education programs for providers, office staff, and new/existing Coders on department policies, procedures, correct coding principles, documentation improvement, and revenue cycle processes.
Develops and maintains Coder job aids, resource materials, and provides guidance on coding-related questions or concerns.
Researches and educates on changes to ICD and CPT codes, and monitors regulatory updates impacting provider
services to develop and disseminate relevant education and process changes.

Associates Degree

3 years of Coding Experience 3 years Coding Experience(HospitalFacility,Professional Fee, Physician Clinic) using ICD and CPT coding and/or knowledge of APC’s, modifiers, and other payment methodologies. Electronic Medical Record (EMR) or Cerner experience.

Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder Hospital (CPC-H), or Registered Health Information Technician (RHIT), Registered Health or Information Administrator (RHIA).