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HIM Inpatient Coding Auditor - REMOTE

extra holidays
Remote: 
Full Remote
Contract: 
Experience: 
Mid-level (2-5 years)
Work from: 

Steward Health Care logo
Steward Health Care XLarge https://www.steward.org/
7646 - 7646 Employees
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Job description

Position Summary

Conducts inpatient coding quality audits to validate code assignment is supported by clinical documentation in the medical record. Highly proficient in the proper assignment of ICD-10-CM and PCS codes. **

Key Responsibilities**

  • Performs coding audits of a wide variety of complex inpatient records to validate the ICD-10-CM, PCS codes, MS-DRG and/or APR DRG assignments.
  • Provides written, detailed rationale and supporting evidence for recommendations on audit findings.
  • Delivers educational feedback to coding staff regarding audit findings.
  • Provides guidance to coding staff and management in identifying and resolving coding issues.
  • Identifies documentation improvement opportunities that impact coding accuracy.
  • Initiates physician queries for clarification of documentation in the medical record to achieve accurate code assignment.
  • Collaborates with the clinical documentation improvement team for conflicts between code assignments.
  • Reviews and researches billing edits.
  • Assists with DRG denials from payers including researching and writing appeal letters.
  • Ability to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding compliance.
  • Maintains a minimum of 95% accuracy on all coding audits.
  • Maintains productivity standard of approximately 20 inpatient coding reviews per day.
  • Performs other duties as assigned including training/mentoring of new staff and performing research related to special projects

Required Knowledge & Skills

(Examples: Ability to work independently and take initiative; Good judgment and problem solving skills; Communication skills; Interpersonal and organizational skills; Level of confidentiality)

  • Comprehensive understanding of coding guidelines, Coding Clinics and appropriate coding references along with the ability to employ these coding resources to audit findings.
  • Excellent interpersonal verbal and written communication skills to accurately relay information to internal and external customers.
  • Excellent organizational skills with ability to trend and track audit findings effectively.
  • Excellent problem solving skills, the ability to work independently, and to perform under pressure in a teamwork manner with diplomacy and tact.
  • Proficient computer and technical skills, along with experience using MS Word, Excel and PowerPoint.
  • Ability to meet assigned deadlines.

Education/Experience/Licensure/Technical/Other

I. Education: Associates degree in Health Information (RHIT), or associates degree in applicable healthcare field.

II. Experience 3-5 years progressive coding experience in acute care hospital setting, including auditing

III. Certification/Licensure: AHIMA certification required, such as RHIA, RHIT or CCS,

IV. Software/Hardware: Meditech and 3M 360 experience required; Cerner experience helpful.

V. Other: This is a remote position, and must live within a Steward hiring state.

VI. Travel: Expected travel is up to 10%. Education and/or company growth.

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Interpersonal Communications
  • Organizational Skills

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