Coding Quality Auditor

Houston Methodist; Nashville (TN); Remote; USD 55,000 - 85,000; Full time

Job summary

An established industry player is seeking a Coding Quality Auditor to ensure the accuracy of coding assignments for outpatient and inpatient encounters. This role involves conducting data quality reviews, maintaining compliance with regulations, and actively participating in quality improvement projects. The ideal candidate will have a strong background in coding, excellent communication skills, and a commitment to high standards of coding quality. Join a forward-thinking organization that values your expertise and offers a competitive sign-on bonus, while working remotely from select states.

Benefits

Sign-On Bonus

Flexible Work Hours

Remote Work

Professional Development Opportunities

Qualifications

• 5+ years of relevant coding experience in inpatient and outpatient settings.
• Associate's degree or higher in a CAHIIM-accredited program required.

Responsibilities

• Ensure accuracy in code assignment for outpatient and inpatient encounters.
• Perform data quality reviews to maintain coding accuracy and compliance.

Skills

ICD-10 Coding

CPT Coding

Data Quality Reviews

Medical Terminology

Communication Skills

Education

Associate's Degree in Health Information Management

Tools

Encoder Applications

Job description

Join to apply for the Coding Quality Auditor role at Houston Methodist.

Come lead with us at Corporate

$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 throughout the department and/or facility.

People Essential Functions

• Interact and communicate effectively with coding team members, HIM, physicians, CDMP nurses, IT, Quality Operations, Case Management, Patient Access, and Business Office.
• Participate in coding section meetings, education in-services, and coder/CDMP meetings. Assist others and share knowledge on coding guidelines.

Service Essential Functions

• Respond promptly to coding/DRG requests from internal and external customers, including the Business Office.
• Initiate queries with physicians for diagnosis and procedure clarification, using established processes.
• Assist with quality assurance reviews, identify improvement opportunities, and recommend enhancements.
• Support Case Management and Patient Access with CPT coding for pre-admission and pre-certification; develop documentation protocols; represent coding in hospital meetings.

Quality/Safety Essential Functions

• Maintain high coding quality standards, accurately assigning ICD-10 and CPT codes according to policies and guidelines.
• Perform accurate DRG and APC assignments based on documentation.
• Review discharge dispositions and correct as needed.
• Abstract data into systems, ensuring accurate diagnoses and procedures.
• Assist with outpatient/inpatient quality reviews and training; adhere to AHIMA standards.
• Compile reports based on data reviews.

Finance Essential Functions

• Code and abstract efficiently, ensuring accuracy and meeting productivity standards.
• Monitor worklists and coding queues to address old or problem accounts.

Growth/Innovation Essential Functions

• Self-evaluate performance, accept feedback, and seek improvement opportunities.
• Contribute ideas for enhancing coding quality and processes.

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

Education

• Associate's degree or higher in a CAHIIM-accredited Health Information Management program, or additional experience in lieu of degree.

Work Experience

• Five years of relevant coding experience, including inpatient, outpatient, or professional fee coding.

Required Licenses and Certifications

• RHIT, RHIA, CCS, CCS-P, or CPC, as applicable to the coding area.

Preferred Licenses and Certifications

• AHIMA ICD-10 Approved Trainer.

Knowledge, Skills, and Abilities

• Demonstrated competency in safe job performance, communication skills, medical terminology, anatomy, physiology, and proficiency with encoder applications.

Additional Requirements

• Business professional attire; no on-call required; travel within and outside Houston area may be necessary.

Houston Methodist is an Equal Opportunity Employer.