Coding Educator & Auditor

Nebraska Methodist Health System; Omaha (NE); On-site; USD 65,000 - 85,000; Full time

Job summary

Nebraska Methodist Health System seeks an experienced Outpatient Education Coordinator/Auditor to lead coding education and audits at the Methodist Corporate Office in Omaha. The role focuses on ICD-10-CM/PCS, CPT coding, and educating staff across inpatient, outpatient, and professional coding services.

The ideal candidate will have an associate degree in Health Information Management, 5+ years in coding, and RHIT/RHIA or CCS/CPC/COC certification with CPMA or CICA within 12 months.

Qualifications

• Minimum associates degree in Health Information Management or related field required.
• Minimum of 5 years in coding of acute care inpatient services or hospital outpatient and/or professional services required.
• RHIT or RHIA and/or CCS or CPC or COC certification required.
• Certification as CPMA or CICA required or must obtain within 12 months of hire.
• Thorough knowledge of ICD-10-CM/PCS and CPT coding required.

Responsibilities

• Train new hires and contract staff by developing a training plan with a defined completion timeframe.
• Audit coding knowledge during probationary period and ensure adherence to guidelines.
• Update education materials with new government rules and code updates.
• Organize education offerings for inpatient and outpatient coding staff and related roles.
• Collaborate with Coding Leadership to improve processes and productivity.
• Resolve APC edits using CPT codes and collaboration with the Business Office on denials.

Skills

Facilitation

Communication

Leadership

Attention to detail

Coding knowledge

Education

Associate degree in Health Information Management

RHIT/RHIA or CCS/CPC/COC certification

Job description

Why work for Nebraska Methodist Health System?

At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.

Job Summary

Location: Methodist Corporate Office

Address: 825 S 169th St. - Omaha, NE

Work Schedule: Mon - Fri, 8:00am to 4:30pm

Responsible for the education, training and auditing of employees in the Coding department.

Responsibilities

Essential Functions

Responsible for training new hires and contract staff by developing training plan with a defined time frame for completion of training.

• Inpatient Coding-ICD-10 Diagnosis and Procedure, as applicable.
• Outpatient Coding, outpatient surgery and professional services, as applicable.
• Current Procedural Terminology (CPT) coding, as applicable.

Performs audits during probationary period of new hires to ensure knowledge and understanding of coding guidelines and policies.

Responsible for the continuation of education in regards to new government rules, regulations, and yearly code updates for all jobs regarding I-10 coding and CPT coding.

• Researches new coding updates.
• Reviews CMS mandates and updates coding directives as needed.
• Reviews Federal Register to ensure compliant coding and reporting.

Organize education offerings for inpatient and outpatient coding staff as well as related jobs regarding coding and reimbursement.

• Has the ability to present information in a quick manner while still getting pertinent information distributed.
• Manages training supply needs, room reservations, and catering (if needed).
• Works with management to identify annual CEU offerings for inpatient and outpatient coders.

Works closely with the Coding Leadership.

• Per direction of Coding Team Manager: reviews and formulates processes for each coder to ensure efficient use of the medical record to ensure productivity standards are being met.
• Cross trains current staff in all processes in their respective job descriptions.
• Contributes to the development and maintenance of specialty-specific coding education materials.
• Identifies documentation trends and issues to bring forward for resolution

Serves as a resource for other departments, physicians and other requestors of education and information on ICD-10.

Serves as a coder when volumes exceed department standards as determined by management.

Performs audits on inpatient or outpatient coders as directed by management.

• Develops and maintain audit spreadsheet for each coder, auditing frequency to be determined in coordination with Coding management.
• Develops individualized education/training plan in coordination with Coding management based on the results of the audits.

Outpatient Education Coordinator/Auditor will resolve APC Edits using CSG Edit Report to ensure all accounts reflect appropriate Current Procedure Terminology (CPT) codes, modifiers, and units of services to facilitate correct outpatient billing as defined by Medicare.

Works in collaboration with Business Office on denials by reviewing submitted charges and coding; resolve issues to enhance account payment timeliness.

Schedule

Mon - Fri, 8:00am to 4:30pm

Job Description

Job Requirements

Education

• Minimum associates degree in Health Information Management or related field required.

Experience

• Minimum of 5 years in coding of acute care inpatient services or hospital outpatient and/or professional services required.

License/Certifications

• Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) and/or Certified Coding Specialist (CCS) or Certified Procedural Coder (CPC) or Certified Outpatient Coder (COC) required.
• Certification as a Certified Professional Medical Auditor (CPMA) or Certified Inpatient Coding Auditor (CICA) required or must obtain within twelve months of hire.

Skills/Knowledge/Abilities

• Skilled in facilitating effective working relationships and building consensus.
• Excellent attention to detail and completeness.
• Must have strong knowledge in both payment methodologies (APC and DRG payment structures) to ensure maximum reimbursement.
• Thorough knowledge of International Classification of Disease (ICD)-10-CM/Procedure Coding System (PCS) and Current Procedural Terminology (CPT) coding required.
• Knowledge of computer systems and software used in functional area.
• Capability to apply judgement and make informed decisions with little guidance.
• Ability to communicate effective, both orally and in writing.
• Ability to plan, organize, prioritize and work independently.
• Ability to solve problems and identify solutions.
• Ability to work effectively both as a team player and as a leader.
• Must be able to handle frequent interruptions throughout the day.

Physical Requirements

Weight Demands

• Sedentary Work - Exerting up to 10 pounds of force. Sitting most of the time. Walking and Standing are required only occasionally.

Physical Activity

• Occasionally Performed (1%-33%):
  • Balancing
  • Carrying
  • Crouching
  • Distinguish colors
  • Grasping
  • Lifting
  • Pulling/Pushing
  • Standing
  • Stooping/bending
  • Twisting
  • Walking
• Frequently Performed (34%-66%):
  • Reaching
  • Speaking/talking
• Constantly Performed (67%-100%):
  • Hearing
  • Keyboarding/typing
  • Repetitive Motions
  • Seeing/Visual
  • Sitting

Job Hazards

• Not Related:
  • Chemical agents (Toxic, Corrosive, Flammable, Latex)
  • Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) (BBF)
  • Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment)
  • Equipment/Machinery/Tools
  • Explosives (pressurized gas)
  • Electrical Shock/Static
  • Radiation Alpha, Beta and Gamma (particles such as X-ray, Cat Scan, Gamma Knife, etc)
  • Radiation Non-Ionizing (Ultraviolet, visible light, infrared and microwaves that causes injuries to tissue or thermal or photochemical means)
  • Mechanical moving parts/vibrations

About Methodist

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.

Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.