Coding Data Quality (DQ) Lead

Position Summary

The Data Quality (DQ) Lead is responsible for driving enterprise-wide improvements in clinical data accuracy, documentation quality, and coding integrity to support operational performance, financial optimization, and risk mitigation. This role plays a central part in enabling the organization to realize the benefits of the 3Terra DQA Conservable Days Module and in preparing for the transition to an internally developed Decision Support (DSU) solution.

The DQ Lead will identify, validate, and close data quality opportunities; reduce conservable days; improve Quality-Based Procedure (QBP) assignment accuracy; and strengthen audit readiness. This position requires strong analytical capability, deep understanding of coding and documentation workflows, and the ability to collaborate with clinical, operational, and financial stakeholders.

Key Responsibilities

1. Data Quality Opportunity Management

• Review, validate, and close data quality opportunities identified through the 3Terra DQA platform, including QBP assignment, LOS/conservable days signals, and documentation gaps.
• Monitor and improve cycle time from opportunity creation to resolution.
• Maintain a structured tracker of opportunities, actions, and outcomes.

2. Coding Accuracy & Documentation Improvement

• Conduct targeted internal audits for high-value cohorts (e.g., hip fracture, QBPs) to assess coding accuracy and documentation completeness.
• Identify error patterns and collaborate with Coding & Abstracting teams to reduce rework and improve audit agreement rates.
• Issue and track documentation queries; monitor query effectiveness and recurring themes.

3. Conservable Days & LOS Optimization

• Analyze conservable days trends and drivers using the 3Terra Conservable Days Module.
• Partner with operational leaders and Decision Support to identify root causes and recommend actionable interventions.
• Track LOS variance against expected benchmarks for selected QBPs.

4. Financial Impact & ROI Tracking

• Quantify incremental funding or revenue recovery attributable to DQ interventions, validated through case totals and FP&A methodology.
• Support quarterly financial impact reviews with Decision Support and FP&A.
• Contribute to ROI reporting using the established framework: ROI (%) = (Annualized Benefits – Annual Investment) / Annual Investment × 100

5. Risk Mitigation & Data Integrity

• Reduce downstream reporting corrections, audit findings, and deficiencies through proactive data quality oversight.
• Decrease the volume of “Project 100” charts requiring coder review due to incomplete documentation.
• Strengthen data integrity for operational, quality, and financial reporting.

6. Stakeholder Engagement & Execution

• Lead monthly DQ dashboard reviews with Coding & Abstracting leadership.
• Coordinate quarterly analytics and financial impact reviews with Decision Support and FP&A.
• Drive adoption of recommendations and track completion rates with operational owners.
• Deliver targeted initiatives with clear recommendations, timelines, and accountability.

Key Performance Indicators (KPIs)

• The DQ Lead will be accountable for monitoring and improving the following KPIs (targets set after 60–90 day baseline):
• Number of DQ opportunities closed (by type)
• Opportunity cycle time
• Internal audit accuracy for targeted cohorts
• Incremental funding projected/realized
• Conservable days (total and rate per 100 discharges)
• LOS variance vs expected for selected QBPs
• Documentation query effectiveness
• Action plan delivery and execution rate
• Internal user adoption of recommendations

Qualifications

Required

• Health Information Management (HIM) diploma or equivalent; CHIM certification preferred.
• 5+ years of experience in coding, abstracting, clinical documentation improvement, or data quality roles.
• Strong understanding of QBP methodologies, case mix grouping, and LOS/conservable days concepts.
• Demonstrated experience with clinical data audits and documentation review.
• Advanced analytical skills with ability to interpret complex datasets.
• Excellent communication and stakeholder engagement skills

Preferred

• Experience with 3Terra DQA or similar data quality platforms.
• Experience working with Decision Support, FP&A, or operational performance teams.
• Knowledge of audit standards, quality reporting frameworks, and financial impact modeling.

Working Conditions

• Full-time position aligned with organizational operational needs.
• Hybrid or on-site work depending on departmental requirements.
• Collaboration with clinical, coding, decision support, and finance teams.

Impact of the Role

• This role directly contributes to:

• Improved coding accuracy and documentation quality
• Reduced conservable days and LOS variance
• Increased QBP and funding optimization
• Enhanced audit readiness and reduced rework
• A validated ROI framework demonstrating measurable organizational benefit