Auditor​/Educator Inpatient

Summary/Objective
For assigned coders and providers, review Inpatient, Outpatient or Professional Fee medical records for coding accuracy and medical record documentation as it impacts the correctness of the coding. Provide feedback and deliver additional education to correct inaccurate coding and improve documentation.

Essential Job Functions

Review medical records for accuracy of coding and data quality. Elements included in reviews may include:

All diagnosis and procedure assigned ICD-10-CM and ICD-10 PCS codes

Evaluation and Management, CPT, HCPCS

Adherence to Guidelines

Teaching Physician Attestations

Use relevant references to perform the Current Procedural Terminology (CPT-4) Official Coding Guidelines, Coding Clinic, CPT Assistant, CMS guidelines, etc.

Communicate effectively with client management, coders, and providers. Provide information regarding work progress, actions, and issues in a timely and effective manner.

Create an action plan that articulates strengths and areas that may require ongoing development to ensure an effective and successful program.

Assist in creating additional learnings that addresses coding problems and documentation gaps.

Solicit feedback from program participants regarding training content or delivery enhancements that would further improve coder/provider effectiveness.

Capitalize on electronic delivery avenues.

Make recommendations to training content, length, delivery, or other aspects of training based on evaluations and feedback from HIM organization/Provider practice.

Keep abreast of training and development research such as learning theory, motivation theory, and new materials, methods, and techniques.

Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.

Key Success Indicators/Attributes

Ability to prioritize and multi-task in a fast-paced, changing environment.

Ability to speak and educate providers face to face.

Demonstrate ability to work in all work types and specialties.

Demonstrate ability to self-motivate, set goals, and meet deadlines.

Demonstrate leadership, mentoring, and interpersonal skills.

Demonstrate excellent presentation, verbal, and written communication skills.

Ability to develop and maintain relationships with key business partners by building personal credibility and trust.

Maintain courteous and professional working relationships with employees at all levels of the organization.

Demonstrate excellent analytical, critical thinking and problem-solving skills.

Skill in operating a personal computer and utilizing a variety of software applications.

Strong presentation skills with an ability to effectively communicate concepts, terminology, and practices.

Capable of delivering training using multiple media, conducting role plays, assessing progress, and measuring training effectiveness.

Demonstrated leadership and problem-solving skills, plus the ability to act/decide accordingly and take initiative.

Ability to collect, create and research complex or diverse information.

Exceptional customer service skills and the ability to plan, organize and exercise sound judgment.

Ability to be positive and flexible in a fast-paced work environment, support management decisions, take responsibility for own actions, lead others to achieve goals, and follow through on commitments.

Strong presentation and written communication skills with an ability to effectively communicate concepts, terminology, and practices.

Capable of developing and delivering training using multiple media, conducting role plays, assessing progress, and measuring training effectiveness.

Strong systems aptitude with a customer orientation and flexibility in work practices.

Ability to work effectively, independently…