Coding Inpatient Auditor

1103 Team Member Services; United States; On-site; USD 76,077,000 - 141,522,000; Full time

Benefits offered by this job

Medical

Dental

Vision Insurance

Life Insurance

Disability Insurance

PTO from Day One

403-B Retirement Plan

Paid Parental Leave

Career Development

Well-being Resources

Mental Health Resources and Support

Pet Benefits

Job summary

AdventHealth in Maitland, FL is seeking a senior clinical coder with extensive inpatient/outpatient coding experience to perform quality reviews of ICD-10, DRG and reimbursement coding. The role includes educating coding staff on changes in guidelines and assisting with DRG appeals to protect reimbursement.

Required RHIA/RHIT/CCS/CPC certifications, strong communication, and the ability to work remotely. Four weeks of paid parental leave and comprehensive benefits accompany the position.

Qualifications

• 5+ years of inpatient or outpatient coding or auditing experience.
• RHIA, RHIT, CCS, CPC certifications.
• Knowledge of Medicare DRGs, APR-DRG and reimbursement systems.
• Ability to work independently in a remote setting.
• Excellent interpersonal, verbal and written communication 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 weaknesses identified during reviews.
• Reviews, analyzes, and interprets clinical documentation; seeks physician clarification and communicates with physicians and allied health personnel.
• Assists with writing appeals to DRG denials from outside agencies, referencing Official Coding Guidelines and Coding Clinic advice to defend DRG assignments.
• Serves as a resource to other departments in the Revenue Cycle to ensure business continuity and optimal revenue cycle management.

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

Job Details

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

Education

• [Required] High School Grad or Equiv
• [Preferred] Technical/Vocational School
• Field of Study: in a related field of study or equivalent technical experience

Work Experience

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

Licenses and Certifications

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

Physical Requirements

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

Pay Range

$26.55 - $49.39

Equal Opportunity Statement

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

Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we’re committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.