Manager Coding Audit, Remote

General Summary

The Manager of Coding Audits will organize audits at all facilities aimed at confirming compliance with health system guidelines as well as with all regulatory agencies (OIG, HSCRC, CMS, NCCI, and OCG). The Manager of Coding Audits will be responsible for the overall auditing of all coders, auditors, and CDI staff to ensure success in coding compliance and documentation improvement.

The Manager of Coding Audits will collaborate with the Coding Manager and/or Manager of Training on the recommendation of Performance Improvement Plans (PIP). The Manager will work with CDI at all facilities to ensure compliance with all guidelines as well as identify opportunities in documentation improvement. The Manager will ensure all auditors have completed departmental orientation prior to performing any auditing functions.

The Manager will participate in coding Roundtable (CRT) discussions.

• Manages, plans, organizes, monitors, and evaluates all auditing functions to ensure effective and efficient operations and compliance with established standards, rules, and regulations.
• Audits ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, observation, and other OP visits.
• Audits inpatient services, including trauma, transplant, and critical care, to ensure accurate assignment of ICD-10-CM and ICD-10-PCS codes, as well as APR‑DRG, SOI, ROM, and POA assignment.
• Focus audits on MHAC, PPC, PSI, PQI, and mortality to identify trends in documentation issues, coding and query opportunities that affect overall reimbursement.
• Assists with development and implementation of the compliance audit plan to ensure adherence to compliant coding practices and address compliance issues related to all federal and state regulatory requirements.
• Manages all external audits to ensure compliance with coding guidelines and facility policies.
• Serves as communicator between Clinical Documentation Specialists and Coding.
• Tracks and reports coding quality accuracy for coding and CDI staff; monitors productivity rate for coding auditors; performs quality assessments on auditors; creates and monitors inpatient case‑mix reports, denials, top APRs to identify patterns, trends, and variances in all assigned APR‑DRGs.
• Updates Sr. Manager of Coding Quality and Education and other key stakeholders on the status and activities pertaining to coding compliance; prepares reports and monitoring documents that identify areas for improvement; conducts regularly scheduled meetings with auditing staff; provides feedback to Manager of Training Education regarding patterns of coding errors needing educational intervention.
• Under the supervision of the Sr. Manager of Coding Quality, hires, orients, and trains new trainers; completes performance evaluations; handles corrective actions; provides an open and goal‑oriented work environment with established clear and concise work procedures and productivity standards; coaches and guides the team to operational excellence and a culture of accountability.
• Complies with AHIMA and ACDIS standards of ethical coding, querying, and coding compliance guidelines; demonstrates support and compliance with the University of Maryland Medical System mission, vision, values statement, goals and objectives, and policies; attends seminars and in‑services as required to remain current on coding issues; attends departmental and interdepartmental meetings and actively participates in committees as assigned.

• Associate’s degree in Health Information Technology or related field, or 7 years of experience;
  Bachelor’s degree in related field preferred.
• 5 years of experience with coding inpatient and outpatient hospital medical records.
• 3 years supervisory experience/management experience required in the coding field, supervising professional/supervisory staff; 5 years auditing experience.
• Managing multi‑facility departments preferred.
• One of the following:
  Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), AHIMA Approved ICD
  10CM
  /PCS Trainer, Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement…