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Inpatient Coding Auditor
4 months ago
POSITION SUMMARY:
Conducts inpatient coding quality audits to validate code assignment is supported by clinical documentation in the medical record. Highly proficient in the proper assignment of ICD-10-CM and PCS codes.
KEY RESPONSIBILITIES:
• Performs coding audits of a wide variety of complex inpatient records to validate the ICD-10-CM, PCS codes, MS-DRG and/or APR DRG assignments.
• Provides written, detailed rationale and supporting evidence for recommendations on audit findings.
• Delivers educational feedback to coding staff regarding audit findings.
• Provides guidance to coding staff and management in identifying and resolving coding issues.
• Identifies documentation improvement opportunities that impact coding accuracy.
• Initiates physician queries for clarification of documentation in the medical record to achieve accurate code assignment.
• Collaborates with the clinical documentation improvement team for conflicts between code assignments.
• Reviews and researches billing edits.
• Assists with DRG denials from payers including researching and writing appeal letters.
• Ability to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding compliance.
• Maintains a minimum of 95% accuracy on all coding audits.
• Maintains productivity standard of approximately 20 inpatient coding reviews per day.
• Performs other duties as assigned including training/mentoring of new staff and performing research related to special projects
REQUIRED KNOWLEDGE & SKILLS:
• Comprehensive understanding of coding guidelines, Coding Clinics and appropriate coding references along with the ability to employ these 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.
• Proficient computer and technical skills, along with experience using 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 certification required, such as RHIA, RHIT or CCS,
IV. Software/Hardware: Meditech and 3M 360 experience required; Cerner experience helpful.
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.
