Houston Methodist
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Coding Quality Auditor
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Houston Methodist . At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or inpatient encounters based on documentation within the electronic medical record, while maintaining compliance with established rules and regulatory guidelines. This role involves performing data quality reviews to ensure data integrity, coding accuracy, and revenue preservation. Additional duties include participating in quality review and performance improvement projects across the department and/or facility. People Essential Functions
Interact and communicate effectively with the coding team, HIM, physicians, CDMP nurses, IT, Quality Operations, Case Management, Patient Access, and Business Office. Participate in coding meetings, education in-services, and share knowledge of official coding guidelines, assisting others as needed. Service Essential Functions
Respond promptly to coding/DRG requests from internal and external customers, including the Business Office. Initiate queries with physicians for diagnosis and procedure clarification, and assist with coding and documentation training. Support quality assurance reviews, identify improvement opportunities, and recommend enhancements. Assist Case Management and Patient Access with CPT coding for pre-admission and pre-certification, and develop documentation protocols for physicians. Quality/Safety Essential Functions
Maintain high coding quality standards, ensuring accurate ICD-10-CM/PCS and CPT codes according to hospital policies and guidelines. Perform accurate DRG and APC assignments based on documentation. Review discharge dispositions and correct data entries as needed. Abstract data into systems, review medical records, and ensure correct coding of diagnoses and procedures. Participate in quality reviews and training of new coders, adhering to AHIMA standards. Finance Essential Functions
Code and abstract data efficiently, monitor worklists, and ensure timely processing to meet productivity standards. Growth/Innovation Essential Functions
Evaluate personal performance, accept feedback, and contribute ideas for improving coding quality and processes. Other duties may be assigned as necessary. Houston Methodist reserves the right to revise job duties as needed. Minimum Education & Experience
Associate's degree or higher in a HIM-accredited program or equivalent experience. Five years of relevant coding experience. Required Licenses & Certifications
RHIT, RHIA, CCS, CCS-P, or CPC, as appropriate for the coding area. Preferred Certifications
AHIMA ICD-10 Approved Trainer. Knowledge, Skills, & Abilities
Proficiency in medical terminology, anatomy, physiology, and electronic medical records. Effective communication skills and ability to work with diverse teams.
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Coding Quality Auditor
role at
Houston Methodist . At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or inpatient encounters based on documentation within the electronic medical record, while maintaining compliance with established rules and regulatory guidelines. This role involves performing data quality reviews to ensure data integrity, coding accuracy, and revenue preservation. Additional duties include participating in quality review and performance improvement projects across the department and/or facility. People Essential Functions
Interact and communicate effectively with the coding team, HIM, physicians, CDMP nurses, IT, Quality Operations, Case Management, Patient Access, and Business Office. Participate in coding meetings, education in-services, and share knowledge of official coding guidelines, assisting others as needed. Service Essential Functions
Respond promptly to coding/DRG requests from internal and external customers, including the Business Office. Initiate queries with physicians for diagnosis and procedure clarification, and assist with coding and documentation training. Support quality assurance reviews, identify improvement opportunities, and recommend enhancements. Assist Case Management and Patient Access with CPT coding for pre-admission and pre-certification, and develop documentation protocols for physicians. Quality/Safety Essential Functions
Maintain high coding quality standards, ensuring accurate ICD-10-CM/PCS and CPT codes according to hospital policies and guidelines. Perform accurate DRG and APC assignments based on documentation. Review discharge dispositions and correct data entries as needed. Abstract data into systems, review medical records, and ensure correct coding of diagnoses and procedures. Participate in quality reviews and training of new coders, adhering to AHIMA standards. Finance Essential Functions
Code and abstract data efficiently, monitor worklists, and ensure timely processing to meet productivity standards. Growth/Innovation Essential Functions
Evaluate personal performance, accept feedback, and contribute ideas for improving coding quality and processes. Other duties may be assigned as necessary. Houston Methodist reserves the right to revise job duties as needed. Minimum Education & Experience
Associate's degree or higher in a HIM-accredited program or equivalent experience. Five years of relevant coding experience. Required Licenses & Certifications
RHIT, RHIA, CCS, CCS-P, or CPC, as appropriate for the coding area. Preferred Certifications
AHIMA ICD-10 Approved Trainer. Knowledge, Skills, & Abilities
Proficiency in medical terminology, anatomy, physiology, and electronic medical records. Effective communication skills and ability to work with diverse teams.
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