AdventHealth
Divisional Coding Quality Auditor & Educator
Remote opportunity with AdventHealth. Shift: Monday- Friday, Full time 8am-5pm.
The Role You Will Contribute The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator is responsible for supporting the operations of the inpatient or outpatient coding teams by completing overall and account-level quality reviews of coding functions. This position assesses staff adherence to coding policies, procedures, and guidelines and regulatory guidance. This role conducts initial audits during the coder onboarding process and supports ongoing quality assurance needs for coding staff. In addition, this position reviews medical records and documentation for coding accuracy, providing feedback and additional education to correct inaccuracies. Responsible for collaborating with clinical documentation integrity specialists and revenue cycle departments when necessary to ensure documentation supports the coding of the claim. Additionally, this role equips staff with the knowledge and skills required to achieve industry best practice levels of performance.
The Value You Will Bring To The Team
Completes timely and accurate quality assurance audits while adhering to inpatient and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into practical recommendations for improvements in standardizing audit policies and procedures and actionable recommendations for improvement.
Uses relevant references to perform audits, including but not limited to: ICD-10-CM/PCS, CPT, Coding Guidelines, Official Coding Guidelines, CPT Assistant, AHA Coding Clinic, CMS guidelines, NCCI guidance, etc.
Provides outcomes of coding quality audit reviews with leadership
Maintains current knowledge of coding principles and guidelines as coding conventions are updated; monitors and analyzes current industry trends and issues for potential organizational impact
Assists with the facilitation of scheduled external audits
Responds to inpatient or outpatient coding questions from assigned coders/providers and provides official inpatient coding references and guidelines
Creates clear and accurate audit findings and recommendations in written audit reports for coders, auditors, managers, and directors
Provides feedback to coding and CDI team members on escalated accounts
Collaborates with providers, AH Clinical, CDI, inpatient and outpatient coding staff to assist with or resolve issues related to medical record documentation and coding
May participate in Iodine Retrospect inpatient reviews in partnership with CDI
Provides input on quality audit metrics to track and visualize on dashboards to report outcomes and improve processes
Serves as point person for regional HIM/Coding teams to support quality audits and maintain reports, scorecards and dashboards
Flags data or analytics limitations, uses critical thinking to address barriers, and escalates issues to leadership
Documents and presents findings and trends from quality audits to HIM/Coding leadership
Reports compliance and/or risk issues to the compliance department and suggests process improvements
Develops educational initiatives and may conduct educational huddles for inpatient coders
Makes recommendations on policy/guideline changes based on trending quality issues
Works with Epic and AIT to identify automation and system enhancements as they pertain to coding
The Expertise And Experiences You8217;ll Need To Succeed
Completion of a coding certificate program
5 years experience coding acute care hospital chart
Thorough understanding of coding processes and workflows
Expert level knowledge of disease pathophysiology and drug utilization
Expert level knowledge of Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI), and Hierarchical Condition Categories (HCC)
Expert level knowledge of medical terminology, coding guidelines and methodologies
Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information
Proficient in MS Office and familiarity with database programs
Ability to effectively learn and perform multiple tasks, and organize work efficiently
Ability to communicate professionally in English, both verbally and in writing
Ability to follow complex instructions with attention to detail
Epic experience
Certified Coding Specialist or Registered Health Information Administrator or Registered Health Information Technician
Preferred Qualifications
5 years of inpatient or outpatient coding or Coding Quality Auditor experience
Associate in HIM field preferred
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category:
Health Information Management
Organization:
AdventHealth Corporate
Schedule:
Full-time
Shift:
Day
Req ID:
25038837
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
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The Role You Will Contribute The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator is responsible for supporting the operations of the inpatient or outpatient coding teams by completing overall and account-level quality reviews of coding functions. This position assesses staff adherence to coding policies, procedures, and guidelines and regulatory guidance. This role conducts initial audits during the coder onboarding process and supports ongoing quality assurance needs for coding staff. In addition, this position reviews medical records and documentation for coding accuracy, providing feedback and additional education to correct inaccuracies. Responsible for collaborating with clinical documentation integrity specialists and revenue cycle departments when necessary to ensure documentation supports the coding of the claim. Additionally, this role equips staff with the knowledge and skills required to achieve industry best practice levels of performance.
The Value You Will Bring To The Team
Completes timely and accurate quality assurance audits while adhering to inpatient and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into practical recommendations for improvements in standardizing audit policies and procedures and actionable recommendations for improvement.
Uses relevant references to perform audits, including but not limited to: ICD-10-CM/PCS, CPT, Coding Guidelines, Official Coding Guidelines, CPT Assistant, AHA Coding Clinic, CMS guidelines, NCCI guidance, etc.
Provides outcomes of coding quality audit reviews with leadership
Maintains current knowledge of coding principles and guidelines as coding conventions are updated; monitors and analyzes current industry trends and issues for potential organizational impact
Assists with the facilitation of scheduled external audits
Responds to inpatient or outpatient coding questions from assigned coders/providers and provides official inpatient coding references and guidelines
Creates clear and accurate audit findings and recommendations in written audit reports for coders, auditors, managers, and directors
Provides feedback to coding and CDI team members on escalated accounts
Collaborates with providers, AH Clinical, CDI, inpatient and outpatient coding staff to assist with or resolve issues related to medical record documentation and coding
May participate in Iodine Retrospect inpatient reviews in partnership with CDI
Provides input on quality audit metrics to track and visualize on dashboards to report outcomes and improve processes
Serves as point person for regional HIM/Coding teams to support quality audits and maintain reports, scorecards and dashboards
Flags data or analytics limitations, uses critical thinking to address barriers, and escalates issues to leadership
Documents and presents findings and trends from quality audits to HIM/Coding leadership
Reports compliance and/or risk issues to the compliance department and suggests process improvements
Develops educational initiatives and may conduct educational huddles for inpatient coders
Makes recommendations on policy/guideline changes based on trending quality issues
Works with Epic and AIT to identify automation and system enhancements as they pertain to coding
The Expertise And Experiences You8217;ll Need To Succeed
Completion of a coding certificate program
5 years experience coding acute care hospital chart
Thorough understanding of coding processes and workflows
Expert level knowledge of disease pathophysiology and drug utilization
Expert level knowledge of Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI), and Hierarchical Condition Categories (HCC)
Expert level knowledge of medical terminology, coding guidelines and methodologies
Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information
Proficient in MS Office and familiarity with database programs
Ability to effectively learn and perform multiple tasks, and organize work efficiently
Ability to communicate professionally in English, both verbally and in writing
Ability to follow complex instructions with attention to detail
Epic experience
Certified Coding Specialist or Registered Health Information Administrator or Registered Health Information Technician
Preferred Qualifications
5 years of inpatient or outpatient coding or Coding Quality Auditor experience
Associate in HIM field preferred
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category:
Health Information Management
Organization:
AdventHealth Corporate
Schedule:
Full-time
Shift:
Day
Req ID:
25038837
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
#J-18808-Ljbffr