Credentialed Inpatient Auditor; Coding Quality Review​/Educator

Position Title:

Credentialed Inpatient Auditor (Coding Quality Review / Educator) WFH (OK, TX, AR, KS, MO)

Department: HIM Coders

Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment.

Ideal candidate will have experience in academic medical center complex inpatient coding.

Performs internal quality assessment reviews on OUH coders to ensure compliance with national coding guidelines and the OUH coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. Helps to coordinate and direct the day-to-day coding educational activities. Facilitates and provides coding educational classes/presentations to staff, as required/when needed. Communicates outcomes to the coding team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments.

Responsibilities also include assisting Coding Leadership in root cause analysis of coding quality issues, performing account reviews, and preparing training documents to assist with coding quality action plans.

• Responds to coding-related questions from HSC coding staff
• Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven) for inpatient coding across OUMS
• Provides Coding Integrity Specialist (CIS) and CQR education as needed
• Initiates the rebilling process as required per policy on special projects
• Researches coding opportunities and escalates as needed
• Assists in the review, improvement of processes, education, troubleshooting and recommend prioritization of issues.
• Provides and creates education as needed
  • Monitors QA results to assist Coding Leadership in root cause analysis and educational opportunities
  • Assists with curriculum development
  • Assists in ensuring coding staff adherence with coding guidelines and policy
• Demonstrates and applies expert level knowledge of medical coding practices and concepts
• Participates on special reviews or projects
• Maintains or exceeds 95% productivity standards
• Maintains or exceeds 95% accuracy
• Meets all educational requirements as stated in current Company policy
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
  • Performs an annual education needs assessment as input to the strategic coding education program and provides this assessment to the Coding Leadership team
  • Communicates Coding topics and/or question trends to Coding Leadership for global education
  • Coaches and mentors coding staff as they develop and grow their coding skills
  • Provides skilled coding support through regularly scheduled coding meetings and as the need arises
  • Researches external sources for common coding trends and questions
  • Works on special projects as assigned
  • Applies adult learning concepts when developing, delivering or assisting others for educational programs
  • Provides high level of customer service
  • Practices and demonstrates adherence to the Company's Code of Conduct and ethics philosophy and Company's Mission and Values
  • Completes other duties as assigned

• Performs other duties as assigned

• Education: High school diploma or GED required. Associate's or Bachelor's degree in HIM/HIT preferred.
• Experience: Minimum of five (5) years acute care inpatient coding experience required. Three (3) years inpatient coding auditing experience strongly preferred.
• License(s)/Certification(s)/Registration(s)
  
  Required:
  
  RHIA, RHIT, CCS, or CPC required.

• Coding Technical/Professional Knowledge and
  
  Skills:
  
  extensive regulatory coding (ICD-10-CM, ICD-10-PCS, CPT-4, Modifiers, MS-DRGs, POA assignment and where applicable APR-DRGs and APCs) and associated reimbursement knowledge
• Effective Decision Making: relating and comparing; securing relevant information and identifying key issues; committing to an action after developing alternative courses of action that take into consideration resources, constraints, and organizational values
• Adaptability: to major changes in work responsibilities or environment; adjusting effectively to work within new work structures, processes, requirements, or cultures
• Initiative: independently takes prompt proactive steps toward problem resolution
• Contributing to Team Success: by actively participating as a member of the team to move the team toward the completion of goals
• Work Standards: setting high standards of performance for self and others; assuming responsibility and accountability for successfully completing assignments or tasks; self-imposing standards of excellence rather than having standards imposed
  • Communication: communicates clearly and concisely, verbally and in writing.
  • Customer…