CDQA Administrative Analyst

Presbyterian Healthcare Services

. Maintain and update enterprise-wide and department coding policies and procedures for PHS .

Posted 10/2/2026full-timeRemote • New Mexico • United StatesJunior💰 $19 - $32 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in coding compliance, auditing processes, and regulatory standards, with a strong focus on ICD-9, CPT-4, and HCPCS. Capable of analyzing audit results and implementing corrective action plans while maintaining effective communication with various stakeholders.

Highest-signal resume keywords

ICD-9/10 KnowledgeCPT-4 KnowledgeHCPCS KnowledgeHealthcare Coding ComplianceAudit Coordination

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Terminology KnowledgeCoding AuditsBilling ReviewsData AnalysisCorrective Action Plans

Soft Skills

Excellent Written CommunicationExcellent Verbal CommunicationDetail OrientedResults OrientedAbility to Work Independently

Tools & Technologies

PHS Coding IT Applications

Industry Keywords

Healthcare ComplianceRegulatory Agency RegulationsPatient Financial ServicesCoding Policies and ProceduresAudit Results Tracking

Tech Stack

Tools & technologies

PHP

About the role

Key responsibilities & impact

Maintain and update enterprise-wide and department coding policies and procedures for PHS
Monitor compliance to external regulatory agency coding rules and regulations
Coordinate internal and external enterprise-wide coding audits across PHS
Summarize and track internal and external audit results
Coordinate and track enterprise-wide training for coding, audit, physician and clinician personnel
Track corrective action plans for identified low performers
Perform medical record and billing reviews of denied and appealed claims
Compile and analyze enterprise-wide coding scorecard metrics for denials, appeals and coding accuracy
Research regulatory agency regulations
Correct patient accounts based on audit findings
Liaise with Information Services, Finance/Patient Financial Services, hospitals, PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and ancillary departments
Maintain accurate, complete and timely documentation
Maintain and disseminate current legal and regulatory information, including ICD-9, CPT-4, HCPCS and APC updates
Research coding, billing and charging compliance issues and implement corrective action plans
Respond to daily coding and auditing inquiries and perform ad-hoc analysis for PHS management
Gather and analyze information and recommend solutions for business issues
Respond to client inquiries by telephone and email
Maintain working knowledge of PHS coding and auditing IT applications
Investigate patient care and billing concerns
Analyze and summarize medical record and account audit data and communicate findings to management
Document inquiry responses and resolutions in information systems
Assist with audit research and documentation

Requirements

What you’ll need

High school diploma/GED required
One year healthcare clinical, coding, auditing, compliance or patient financial services related experience
Excellent written and verbal communication skills
Detail and results oriented
Ability to work independently
Medical terminology knowledge required
ICD-9/10 knowledge required
CPT-4 knowledge required
HCPCS knowledge required
Must be based in New Mexico
Work shift: Days (United States of America)

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
Short-term disability insurance
Long-term disability insurance
Group term life insurance
Other optional voluntary benefits
Employee Wellness rewards program
Gift cards for participating in wellness activities