HIM Coding Auditor Lead - REMOTE
Job Description
POSITION SUMMARY:
The HIM Outpatient Coding Auditor Lead is an advanced level position for an experienced and proficient Outpatient Coding Auditor. This position provides support to the Manager of HIM Coding Audit and Education. The HIM Outpatient Auditor Lead conducts outpatient coding quality audits as time permits to validate code assignment is supported by clinical documentation in the medical record. The HIM Outpatient Coding Auditor Lead position is highly proficient in the proper assignment of ICD-10-CM, CPT, and HCPCS codes as well as modifiers.
KEY RESPONSIBILITIES:
• As time permits, performs coding audits of a wide variety of complex outpatient services including outpatient surgical, observation, emergency department, diagnostic outpatient, clinic, and series accounts. Also prefer experience in interventional radiology, E&M leveling and coding of injections and infusions.
• Provides written, detailed rationale and supporting evidence for recommendations on all Coding audit findings.
• Delivers educational feedback to coding staff regarding audit findings.
• Collaborates with HIM Outpatient Coding Educator on any educational needs identified for Outpatient Coders.
• Provides guidance to coding staff and management in identifying and resolving coding issues.
• Identifies documentation improvement opportunities that impact coding accuracy.
• Review and research billing edits.
• Ability to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding compliance.
• Assists HIM Coding Audit and Education Manager with monthly coding audits and reports; runs reports from Meditech to identify accounts to audit.
• Maintains a minimum of 95% accuracy on all coding audits.
• As time permits, maintains productivity standard for outpatient coding reviews, dependent upon type of review.
o Emergency Department – 8 per hour
o Same Day Surgery – 4 per hour
o Observation – 4 per hour
o Cardiac Cath/IVR – 3 per hour
o Ancillary – 20 per hour
o Oncology Infusions – 6 per hour
o Wound Care – 5 per hour
• Performs other duties as assigned including training/mentoring of new staff and performing research related to special projects
REQUIRED KNOWLEDGE & SKILLS:
(Examples: Ability to work independently and take initiative; Good judgment and problem solving skills; Communication skills; Interpersonal and organizational skills; Level of confidentiality)
• Comprehensive understanding of coding guidelines, CCI edits, Coding Clinics and CPT assistant, along with ability to employ coding resources to audit findings.
• Excellent interpersonal verbal and written communication skills to accurately relay information to internal and external customers.
• Excellent organizational skills with ability to trend and track audit findings effectively.
• Excellent problem-solving skills, the ability to work independently, and to perform under pressure in a teamwork manner with diplomacy and tact.
• Highly proficient computer and technical skills, including MS Word, Excel, and PowerPoint.
• Ability to meet assigned deadlines.
EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:
I. Education: Associates degree in Health Information (RHIT), or associates degree in applicable healthcare field.
II. Experience 3-5 years progressive coding experience in acute care hospital setting, including auditing
III. Certification/Licensure: AHIMA or AAPC certification required, such as RHIA, RHIT, CCS, CIRCC, CPC, COC
IV. Software/Hardware: Meditech and 3M 360 experience required
V. Other: This is a remote position and must live within a Steward hiring state.
VI. Travel: Expected travel is up to 10%. Education and/or company growth.
About Steward Health Care
Over a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country's largest physician-led, minority-owned, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.
Based in Dallas, Steward currently operates more than 30 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, and Texas.
For more information, visit steward.org
Application Instructions
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