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Outpatient Coding Quality Auditor I
2 months ago
Overview:
*CHRISTUS Health System presents the Coding Quality Specialist I role as a remote opportunity. Candidates must reside in specific states to be considered for this position.*
The Coding Quality Specialist is accountable to the HIM Coding Education Manager, conducting internal coding assessments to support the operational needs of the Coding Department. This role plays a vital part in coding education and training, facilitating pre-bill and cross-training to enhance the competencies of our coding associates.
The Coding Quality Specialist showcases extensive knowledge and understanding of current coding guidelines, including ICD-10-CM, ICD-10-PCS, and CPT/HCPCS, maintaining a high accuracy rate in both inpatient and outpatient settings.
Responsibilities are determined by departmental requirements and encompass various reviews such as PEPPER assessments, new hire evaluations, standard pre-bill reviews, remediation, performance improvement reviews, and other focused assessments as necessary. The Coding Quality Specialist will evaluate quality concerning POA assignment, diagnosis code assignment, procedural coding, modifier usage, discharge disposition verification, query opportunities, and accuracy of DRG and APC assignments.
This role involves collaboration with multiple CHRISTUS Health Departments, including Regional Coding Managers, HIM, Compliance, and Clinical Documentation Specialists, ensuring that feedback is effectively communicated for educational purposes. The Coding Quality Specialist may also assist in production coding to maintain up-to-date skills and adapt to evolving technologies and workflows.
The Coding Quality Specialist will report directly to the HIM Coding Education Manager, with additional guidance from the Director of Coding Operations and System HIM Director.
Key Responsibilities:
- Meet the expectations of the OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
- Conduct inpatient and outpatient coding reviews.
- Communicate findings clearly in both verbal and written formats to support training and education initiatives.
- Assist in developing and coordinating review plans, providing feedback to coding staff and management regarding documentation and coding accuracy.
- Support chart sample selection for reviews and ensure proper randomization with Coding Managers.
- Contribute to the formulation of an annual work plan for targeted chart reviews and pre-bill assessments.
- Collaborate with the Coding Integrity Department to recommend content for Job Aides and Coding Best Practice references, enhancing coder knowledge and expertise.
- Achieve or exceed an accuracy rate of 95%.
- Ensure the effectiveness of coding reviews through associate evaluations.
- Exhibit strong written and verbal communication skills.
- Work independently in a remote environment with minimal supervision.
- Perform additional duties as assigned by the Manager.
Qualifications:
- High school diploma or equivalent experience required.
- Completion of an accredited Baccalaureate in Health Informatics or Health Information Management, or an AHIMA approved Coding Certificate Program is preferred.
- Five (5) or more years of inpatient and/or outpatient coding experience in an acute care environment is preferred.
- Registered Health Information Administrator (RHIA) certification (AHIMA) is required.
- Registered Health Information Technician (RHIT) certification (AHIMA) is required.
- Certified Coding Specialist (CCS) certification (AHIMA) is required.
Work Type:
Full Time
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