University of Maryland Medical System
Coding Compliance Auditor, Inpatient
University of Maryland Medical System, Baltimore, Maryland, United States, 21276
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Company Description
The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you’ll enjoy as a member of our team. Job Description
Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. Responsibilities
Serve as a clinical coding subject matter expert and consult with medical and clinical staff, and clinical documentation specialists as needed. Audit ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, and observation visits for reimbursement, research and compliance with federal and state regulations. Audit complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment. Provide advisory and educator role for Coding Specialists; communicate between Clinical Documentation Specialists & Coding; research new surgical procedures and technology; provide training to new employees. Report coding quality accuracy rate for each coder; monitor productivity rate for each coder; conduct specialized focused audits as needed. Communicate with various departments regarding coding accuracy; refer any problems to management timely; assist coding specialists in writing appropriate coding queries; collaborate with CDI; understand PPC/MHAC/QI indicators and impact as needed. Comply with AHIMA standards of ethical coding and coding compliance guidelines. Demonstrate support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies. Perform other duties or projects such as coding corrections as assigned by the manager. Qualifications
High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training. Associates or Bachelor’s degree. Education will be considered in lieu of experience. Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience at a Level 1 Trauma hospital; or 4 years of experience with coding inpatient hospital medical records; 2-3 Years Ambulatory coding experience. One of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC). Skills
Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability. Additional Information
All your information will be kept confidential according to EEO guidelines. Compensation
Pay Range: $33.36 - $46.70 Other Compensation (if applicable): Review the 2024-2025 UMMS Benefits Guide Like many employers, UMMS is being targeted by cybercriminals impersonating our recruiters and offering fake job opportunities. We will never ask for banking details, personal identification, or payment via email or text. If you suspect fraud, please contact us at careers@umms.edu.
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The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you’ll enjoy as a member of our team. Job Description
Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. Responsibilities
Serve as a clinical coding subject matter expert and consult with medical and clinical staff, and clinical documentation specialists as needed. Audit ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, and observation visits for reimbursement, research and compliance with federal and state regulations. Audit complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment. Provide advisory and educator role for Coding Specialists; communicate between Clinical Documentation Specialists & Coding; research new surgical procedures and technology; provide training to new employees. Report coding quality accuracy rate for each coder; monitor productivity rate for each coder; conduct specialized focused audits as needed. Communicate with various departments regarding coding accuracy; refer any problems to management timely; assist coding specialists in writing appropriate coding queries; collaborate with CDI; understand PPC/MHAC/QI indicators and impact as needed. Comply with AHIMA standards of ethical coding and coding compliance guidelines. Demonstrate support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies. Perform other duties or projects such as coding corrections as assigned by the manager. Qualifications
High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training. Associates or Bachelor’s degree. Education will be considered in lieu of experience. Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience at a Level 1 Trauma hospital; or 4 years of experience with coding inpatient hospital medical records; 2-3 Years Ambulatory coding experience. One of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC). Skills
Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability. Additional Information
All your information will be kept confidential according to EEO guidelines. Compensation
Pay Range: $33.36 - $46.70 Other Compensation (if applicable): Review the 2024-2025 UMMS Benefits Guide Like many employers, UMMS is being targeted by cybercriminals impersonating our recruiters and offering fake job opportunities. We will never ask for banking details, personal identification, or payment via email or text. If you suspect fraud, please contact us at careers@umms.edu.
#J-18808-Ljbffr