Coding Auditor Educator (REMOTE)

Virtua Health; Marlton (NJ); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Coding Auditor Educator to ensure coding quality and compliance in a dynamic healthcare environment. This role involves developing training materials, conducting audits, and collaborating with various departments to resolve coding issues. The ideal candidate will have extensive experience in inpatient and outpatient coding, along with a strong background in ICD-10-CM/PCS and CPT coding. Join a forward-thinking organization that values education and quality, and play a crucial role in shaping coding standards and practices while making a meaningful impact on patient care.

Qualifications

• Minimum 3 years of hospital coding experience required.
• Knowledge of ICD-10-CM/PCS and CPT-4 essential.

Responsibilities

• Responsible for coding quality and standards development.
• Provides training for newly hired coders and monitors their progress.

Skills

Inpatient Coding

Outpatient Coding

Training Development

ICD-10-CM/PCS

CPT Coding

Compliance Auditing

Education

Bachelor’s Degree in Health Information Management

Coding Certificate

Tools

Microsoft Office

Coding Resources

Job description

Join to apply for the Coding Auditor Educator (REMOTE) role at Virtua Health.

6 days ago Be among the first 25 applicants.

• Will require occasional travel to South Jersey.
• Requires experience in both inpatient and outpatient coding.
• Ability to develop training materials to educate the coding team.
• CCS preferred.

Job Summary

Responsible for hospital coding quality and standards development for ICD-10-CM/PCS, CPT, and HCPCS codes for the Health Information Management department. This includes performing internal audits, overseeing external audits, and providing education and training to hospital coders. Responsible for working with other hospital departments to resolve coding issues that affect account processing. Develops, implements, and maintains a compliance plan for hospital coding and abstracting. Participates in system administration maintenance duties for coding and abstracting software.

Position Responsibilities

Training and Education

Provides training and education for newly hired coders; checks their coding, abstracting, and querying; tracks progress; and audits their work. Develops coding and training resources (modules, scenarios, tip sheets, etc.). Assists in coordinating and reconciling between CDI specialists and coders. Educates, monitors, and reports on productivity and quality standards. Responds to daily coding questions regarding complex accounts.

Review And Resolution Of Interdepartmental Coding-related Issues

Works closely with Patient Accounting, Case Management, Quality Management, and other departments to resolve coding and reimbursement issues. Serves as an escalation point for coding requirements questions. Educates staff, including physicians and billers, on hospital coding. Recommends policy, procedure, charge master, and documentation changes to ensure appropriate reimbursement.

Auditing

Performs audits to monitor coding quality and compliance. Conducts specialized audits for quality improvement and compliance initiatives. Manages external quality audits, including distributing results, preparing rebuttals/appeals, and taking corrective actions. Reviews and responds to Payor Audits involving DRG and coding changes. Provides feedback and improvement recommendations.

Accounts Receivable

Monitors hospital Discharge Not Final Billed reports. Troubleshoots and resolves complex account problems to facilitate appropriate reductions in A/R. Codes charts as needed to meet A/R goals. Coordinates with campuses to improve operational coding workflows.

Policies And Procedures

Develops and enforces policies on coding, data abstraction, and compliance. Provides feedback to supervisors and staff.

Coding, Abstracting And State Data System Maintenance

Maintains and updates systems for billing, state data collection, and hospital statistics. Resolves system issues with IS and vendors. Designs testing tools, participates in testing and validation, and manages system upgrades and downtime.

Qualifications

Experience: Minimum 3 years hospital inpatient and outpatient coding experience. Knowledge of ICD-10-CM/PCS, CPT-4, DRGs, APCs, and CMI required. Experience with multiple service lines preferred. Proficiency in PC applications, Microsoft Office, encoder, and coding resources required.

Education: Bachelor’s or Associate’s Degree in HIM, Coding Certificate, or equivalent experience with certification eligibility.

Certifications: CCS certification by AHIMA required; RHIA/RHIT preferred.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Accounting/Auditing and Finance
• Industries: Hospitals and Healthcare