Coding Inpatient Auditor

AdventHealth; Town of Florida (NY); On-site; USD 36,000 - 68,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

Life Insurance

Disability Insurance

Paid Time Off from Day One

403-B Retirement Plan

Parental Leave - 4 Weeks

Career Development

Well-being Resources

Mental Health Resources

Pet Benefits

Job summary

AdventHealth is seeking a skilled Coding Auditor/Quality Reviewer to join our Revenue Cycle team in Florida. You will perform quality reviews of coded records for ICD-10, ICD-10-PCS, MS-DRG and APR-DRG accuracy, while educating staff on changes in the coding and reimbursement landscape.

You will interpret clinical documentation, request clarifications from physicians, and help write compelling DRG appeals to defend assignments and protect reimbursement.

Qualifications

• Proven knowledge of Medicare DRGs, APR-DRG, coding guidelines and reimbursement systems.
• Excellent interpersonal, verbal, and written communication skills; proficient in physician relations.
• Computer skills including 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 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.

Skills

Critical thinking

Communication skills

Independent remote work

Education

High School Grad or Equiv

Technical/Vocational School

Tools

Microsoft Office

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:

(Please click the link below to view work 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.