Coding Inpatient Auditor

AdventHealth; Florida; On-site; USD 37,000 - 68,000; Full time

Job summary

AdventHealth in Maitland, Florida is seeking a skilled coding professional to perform quality reviews of coded records and to educate staff on coding changes. This role supports DRG assignments and reimbursement integrity across the revenue cycle.

Applicants should have 5+ years of inpatient/outpatient coding experience, RHIA/RHIT/CCS/CPC certifications, and the ability to work independently, including remote collaboration with clinicians and coders.

Qualifications

• Expansive knowledge of Medicare DRGs, APR-DRG, coding guidelines and reimbursement systems.
• Excellent verbal and written communication, physician relations.
• Proficient in Microsoft Office and Encoder software.
• Self-motivated and able to work independently in a remote setting.
• Critical thinking and problem-solving skills.

Responsibilities

• Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS-DRG, APR-DRGs, and overall coding accuracy retrospectively and concurrently.
• Provides continuing education to individual coders and the coding staff concerning changes in the coding and reimbursement system.
• Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist.
• Assists with writing compelling appeals to all DRG denials from outside agencies to defend the DRG assignment.
• Serves as a resource to other departments in Revenue Cycle for business continuity and revenue optimization.

Skills

Medicare DRGs knowledge

Interpersonal communication

MS Office proficiency

Encoder software

Education

High School Grad or Equiv

Technical/Vocational Training

Tools

Encoder software

Job description

Our promise to you

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule

Full time

Shift

Day (United States of America)

Address

900 WINDERLEY PL

City

MAITLAND

State

Florida

Postal Code

32751

Job Description

• Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS-DRG, APR-DRGs, and overall coding accuracy retrospectively and concurrently.
• Provides continuing education to individual coders and the coding staff concerning changes in the coding and reimbursement system and any weaknesses identified during the coding validation reviews.
• Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist, and effectively communicates with physicians and allied health personnel.
• Assists with writing compelling appeals to all DRG denials from outside agencies, referencing Official Coding Guidelines and Coding Clinic advice as appropriate to defend the DRG assignment and protect the organization’s reimbursement.
• Serves as a resource to other departments in the Revenue Cycle to ensure business continuity and optimal revenue cycle management.

Knowledge, Skills, and Abilities

• Expansive knowledge of Medicare DRGs, APR-DRG, coding guidelines and guidance materials, and reimbursement systems. [Required]
• Excellent interpersonal, verbal, and written communication skills; proficient in and demonstrate excellent physician relations. [Required]
• Computer skills, including Microsoft Office and Encoder software. [Required]
• Self-motivated and able to work independently in a remote setting. [Required]
• Critical thinking and problem-solving skills [Required]

Education

• High School Grad or Equiv [Required]
• Technical/Vocational School [Preferred]

Field of Study

• in a related field of study or equivalent technical experience

Work Experience

• 5+ years of inpatient of outpatient coding or auditing experience [Required]

Licenses and Certifications

• Registered Health Information Administrator (RHIA) [Required] or
• Registered Health Information Technician (RHIT) [Required] or
• Certified Coding Specialist (CCS) [Required] or
• Certified Professional Coder (CPC) [Required]

Physical Requirements

Physical Requirements - https://tinyurl.com/23km2677

Pay Range

$26.55 - $49.39

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.