Quality Coding Analyst

Newport Mental Health (NMH) is a progressive high-energy organization that uses a person-centered recovery approach to help individuals recover from mental illness and substance use disorders. NMH offers trauma-informed evidence-based services to children, adolescents, families, and adults, including outreach, specialized programs, mental health therapy, school-based therapy, substance use therapy, community-based therapy, and outpatient clinic services.

The mission is to improve clients' lives in Newport County by providing high-quality care with a focus on inclusion and empowerment for underrepresented communities.

The Quality Coding Analyst supports the organization’s quality reporting and reimbursement objectives by ensuring complete, accurate, and compliant clinical quality measure (CQM/eCQM) coding and data capture. This role partners with clinical, quality, Health Information Management (HIM), revenue cycle, and IT teams to validate documentation, abstract and code quality measure data elements, and troubleshoot measure logic and workflows. The analyst applies healthcare billing management expertise to align coding and billing practices, optimize reimbursement, and reduce denials and audit risk.

Responsibilities include performing quality measure abstraction and coding for various programs, validating clinical documentation and coded data (ICD-10-CM/PCS, CPT/HCPCS, modifiers), collaborating to improve EHR workflows, conducting quality audits and reconciliations, submitting and managing electronic claims, maintaining billing policies and procedures according to regulations, ensuring billing accuracy, analyzing accounts receivable data, preparing measure documentation to support audits, developing reports and presentations, and maintaining knowledge of pertinent regulations such as HIPAA and CMS guidelines.

Additional duties involve attending trainings, participating in safety drills, and performing tasks assigned by supervisors or management.