Coding Auditor Educator (REMOTE)

Lensa; United States; Remote; USD 64,000 - 96,000; Full time

Job summary

A leading healthcare organization is seeking a Coding Specialist to ensure coding quality and standards for their Health Information Management department. This role involves training staff, conducting audits, and collaborating with various departments to resolve coding issues. The position is fully remote, requiring experience in inpatient and outpatient coding, and offers a supportive work environment dedicated to community health.

Qualifications

• 3 years hospital inpatient and outpatient experience required.
• Ability to develop and present education presentations required.

Responsibilities

• Responsible for hospital coding quality and standards development.
• Providing training and education for newly hired coders.
• Performing audits to monitor coding and abstracting quality.

Skills

ICD-10-CM

CPT

HCPCS

Microsoft Office

Education

Bachelor or Associates Degree in HIM

Coding Certificate Program

Tools

PC database applications

encoder

Job description

1 day ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, Virtua Health, is seeking professionals. Apply via Lensa today!

At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between – we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment.In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations (https://www.virtua.org/locations) , we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program (https://www.virtua.org/about/eat-well) , telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics.

Location:

100% Remote

Currently Virtua welcomes candidates for 100% remote positions from: AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV only.

Employment Type

Employee

Employment Classification

Regular

Time Type

Full time

Work Shift

Total Weekly Hours:

40

Additional Locations:

Job Information

• Will require occasional travel to South Jersey
• Requires experience in both inpatient and outpatient coding
• Ability to develop training materials to educate 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 the hospital coders. Responsible for working with other hospital departments to resolve all coding issues that prevent accounts from being processed appropriately. Responsible for developing, implementing and maintaining compliance plan for hospital coding and abstracting. Responsible for participating in system administration maintenance duties for coding and abstracting software.

Position Responsibilities

Training and Education:

Providing training and education for newly hired coders; checking their coding, abstracting, and querying; tracking their progress; and auditing their work once they are released. Developing coding and training resources for the entire coding team (modules, scenarios, tip sheets, etc.). Assisting in the coordination, synchronization, and reconciliation between CDI specialists and coders. Assisting in educating, monitoring, and reporting on productivity and quality standards. Researching and responding to daily questions from all coders regarding the correct application of coding guidelines for complex accounts.

Review And Resolution Of Interdepartmental Coding-related Issues

Working closely with Patient Accounting, Case Management, Quality Management, and other hospital departments to resolve coding and reimbursement issues. Serving as an escalation point and answering questions regarding coding requirements. Providing education to their staff, including physicians and physician billers, on hospital coding billers. Recommending changes to policies, procedures, charge master and documentation requirements to insure appropriate reimbursement

Auditing

Performing audits to monitor coding and abstracting quality and compliance. Performing specialized audits to facilitate quality improvement and compliance (RAC, PEPPER, OIG initiatives). Processing external quality audits, which includes distributing results, preparing rebuttals/appeals, and taking appropriate action with responses (including correcting data and educating coders). Reviewing and responding to Payor Audits involving DRG and coding changes. Providing feedback with recommendations for improvement.

Accounts Receivable

Assisting with monitoring of hospital Discharge Not Final Billed reports. Troubleshooting and resolving complex problems with individual accounts in order to facilitate appropriate reductions in A/R and accounts held for coding. Coding charts when urgently needed to facilitate A/R goals. Working closely with all campuses to provide efficiencies in operational coding workflow, adjustment in workflow queues, etc.

Policies And Procedures

Developing policies and procedures on coding, data abstraction and Corporate Compliance for Health Information Management. Documenting and enforcing policies and procedures for HIM, and providing feedback to appropriate supervisors and/or staff.

Coding, Abstracting And State Data System Maintenance

Maintaining and updating systems to collect accurate data for billing and state data collection, as well as hospital statistical requirements. Identifying and resolving problems with the assistance of IS and vendor counterparts. Designing testing tools and participating in testing and validation of code sets, coding and abstracting programs. Supporting scheduled and unscheduled system upgrades. Managing downtime, and putting back-up plans into place.

Position Qualifications Required

Required Experience:

3 Years Hospital Inpatient And Outpatient Experience Required

Experience with multiple service lines preferred (cardiac, obstetrics, orthopedics, medical-surgical, etc.)

Knowledge of PC database applications, Microsoft Office, spreadsheet design, encoder required.

Subject matter expertise in the areas of ICD-10-CM and PCS, CPT-4, DRGs, APCs and CMI required.

Ability to develop and present education presentations required

Required Education

Bachelor or Associates Degree in HIM, or Coding Certificate Program, or equivalent experience, leading to appropriate certification.

Training / Certification / Licensure

Certification as CCS by AHIMA

RHIA/RHIT certification preferred

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Accounting/Auditing and Finance

• Industries

  IT Services and IT Consulting

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