PB Cardiac Coding Educator​/Auditor -Cardiac- Remote

Overview

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The Coding Educator Auditor will coordinate coding audits and education functions of LCMC system coding services. This individual will be responsible for managing and working the edit and denial coding work queues for inpatient, outpatient and ambulatory settings and will provide coding feedback for education opportunities identified to the coding team. Prepares and presents educational programs related to coding. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, understand current professional coder workflows, and review principal, secondary diagnoses and procedures for hospital and physician (professional) services for inpatient and outpatient records based on knowledge of coding systems, including ICD-10 and CPT.

• Reviews cases for accurate coding, monitoring the assignment and sequencing of ICD-10-CM/PCS and CPT codes to facilitate the correct assignment of diagnostic and procedure codes.
• Sequences diagnoses and procedures accurately according to coding principles.
• Reviews non-CC/MCC records to determine if the record was miscoded or if additional documentation is needed.
• Works coding edits work queues and provides feedback and coding education to coding staff regarding completeness and accuracy of code assignment.
• Utilizes retrospective edit tool to address possible coding and/or documentation issues related to submitted diagnosis and procedure information obtained from the health record.
• Reviews discrepancies between Clinical Documentation Specialist (CDS) DRG and the Coder DRG.
• Performs reviews in a timely manner to maintain DNFB within the assigned targeted goals.
• Assist in the development and provides ICD-10-CM/PCS, CPT/HCPCS, DRG (MS & APR) and APC auditing, coding and reimbursement training.
• Monitor and report the coder's progress through the orientation and training processes.
• Establish timelines for training completion specific to the level of training necessary.
• Keeps abreast of new regulatory requirements, annual revisions to the codes, etc., and applies this information appropriately.
• Works as subject matter expert and provides expertise when applicable.
• Performs and reports research on topics related to health information management, coding, billing and related compliance issues.
• Ensures audit findings and trends are investigated and education is prepared and reviewed with coding staff when necessary.
• Monitors changes in laws, regulations, standards as they affect coding, billing and related compliance.
• Reads, analyzes and interprets laws, regulations, policies and procedures governing the healthcare revenue cycle.
• Identifies potential areas of compliance vulnerability and risk, develops potential corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
• Prepares and distributes audit results/reports for the system coding program to Coding management staff.
• Works with coding Manager to improve coding services provided by coding staff.
• Assist system coding leadership with training and/or development of a performance improvement track for coding staff in the disciplinary process related to quality or productivity performance.
• Performs special coding-related projects as assigned.
• Other duties as assigned.

• Experience: 5 years in physician and hospital coding, 2 years of coding audit (LCMC).
• Preferred: experience in Cardiology on PB or HB side.

• Required: Associate's Degree in Health Information Management (LCMC).

• Certified Inpatient Coder (CIC) — Required;
  Issuer:
  American Academy of Professional Coders (AAPC);
  Entity: LCMC.
• Certified Professional Coder (CPC) — Required;
  Issuer: AAPC;
  Entity: LCMC.
• Certified Coding Specialist (CCS) — Required;
  Issuer: CCHIIM;
  Entity: LCMC.
• Registered Health Information Technician (RHIT) — Issuer: CCHIIM/AHIMA;
  Entity: LCMC.
• Registered Health Information Administrator (RHIA) — Issuer: CCHIIM/AHIMA;
  Entity: LCMC.

• Knowledge of electronic health records, health information systems and healthcare…