Coding Quality Auditor

Houston Methodist; Los Angeles (CA); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a Coding Quality Auditor to ensure accuracy in code assignments for medical encounters. This fully remote role requires expertise in coding, medical terminology, and effective communication. The successful candidate will engage with various healthcare teams, participate in quality assurance reviews, and contribute to performance improvement initiatives. If you have a passion for maintaining high coding standards and want to be part of a dynamic team focused on quality and innovation, this opportunity is for you.

Benefits

$5,000 Sign-On Bonus

Qualifications

• 5+ years of relevant coding experience required.
• Proficiency in coding and medical terminology essential.

Responsibilities

• Ensure accuracy in code assignment for outpatient and inpatient encounters.
• Participate in quality review and performance improvement projects.

Skills

Coding proficiency

Medical terminology

Anatomy and physiology knowledge

Effective communication

Customer service orientation

Education

Associate's degree in health information management

Relevant certifications (RHIT, RHIA, CCS, CCS-P, CPC)

Tools

Electronic medical records systems

Encoder applications

Job description

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$5,000 Sign-On Bonus - 100% remote, must live in TX, LA, FL, TN, WA, or GA

At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or inpatient encounters based on documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. This role performs data quality reviews to ensure data integrity, coding accuracy, and revenue preservation. Additional duties include participating in quality review and performance improvement projects across the department and/or facility.

People Essential Functions

1. Interacts and communicates effectively with members of the coding team, HIM, physicians, CDMP nurses, IT, Quality Operations, Case Management, Patient Access, and Business Office.
2. Participates in coding section meetings, coding education in-services, and coder/CDMP meetings. Takes initiative to assist others and shares knowledge on coding guidelines.

Service Essential Functions

1. Responds promptly to internal and external customer coding/DRG requests and assists with coding accuracy and documentation clarification.
2. Initiates queries with physicians for diagnosis/procedure clarification and supports Clinical Documentation Management Program (CDMP).
3. Assists with quality assurance reviews, identifies improvement opportunities, and makes recommendations.
4. Supports Case Management and Patient Access in coding for pre-admission and pre-certification requirements.

Quality/Safety Essential Functions

1. Maintains high coding quality standards, assigns accurate codes, and reviews discharge dispositions for data accuracy.
2. Ensures correct physician identification and procedure dates, abstracts data accurately, and adheres to ethical coding standards.
3. Participates in outpatient/inpatient account reviews and training of new coders, and compiles reports for management.

Finance Essential Functions

1. Codes and abstracts efficiently, ensuring productivity and accuracy, and monitors work queues for old or problem accounts.
2. Helps meet coding bill hold goals and maintains timely processing of work items.

Growth/Innovation Essential Functions

1. Self-evaluates performance, accepts feedback, and seeks improvements. Contributes ideas for enhancing coding quality and processes.

This description is not exhaustive; other related duties may be assigned. Houston Methodist reserves the right to revise duties as needed.

Minimum Qualifications

• Associate's degree or higher in a health information management program or equivalent experience.
• Five years of relevant coding experience.
• Required certifications: RHIT, RHIA, CCS, CCS-P, or CPC.

Knowledge, Skills, and Abilities

• Proficiency in coding, medical terminology, anatomy, and physiology.
• Experience with electronic medical records and encoder applications.
• Effective communication skills and customer service orientation.