Coding Quality Auditor

Medasource

Orlando (FL)

Remote

USD 65,000 - 88,600

Full time

14 days+

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Benefits offered by this job

Vision insurance

Medical insurance

Job summary

A leading healthcare organization seeks a Coding Quality Auditor and Specialist responsible for maintaining coding compliance and improving documentation quality. The role demands collaboration with clinical teams to enhance care representation and assure adherence to regulations. Candidates should possess relevant certifications and strong communication skills.

Qualifications

Five years of coding experience in area of expertise.
Clinical expertise and understanding achieved through prior experience working with clinical documentation teams.

Responsibilities

Collaborates with clinical documentation team to identify documentation improvement opportunities.
Assesses DRG, PDx, secondary Dx, PCS, POA components impacting quality metrics.
Identifies strategic plans resulting in positive impact to clinical dashboard.

Skills

Critical Thinking

Excellent Verbal Skills

Excellent Written Skills

Interpersonal Skills

Planning and Time Management

Educational/Training Experience

Education

Bachelor Degree – Healthcare related

RHIT or RHIA or CCS Certification

Certified Clinical Documentation Specialist

Master’s Degree in related field (preferred)

Job description

Title: Coding Quality Auditor and Specialist, HB Coding

Duration: Full Time Employment

Location: 100% Remote (occasional onsite meeting attendance may be required)

Start Date: ASAP

Job Description:

The Coding Quality Auditor and Specialist, HB Coding reflects the mission, vision, and values of our in-client and adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Coding Quality Auditor and Specialist is required to be the expert in the work related to clinical documentation and coding. This position works in tandem with the Clinical Documentation Team assuring quality metrics are held to the highest standard for our in-client.

The Coding Quality Auditor and Specialist is responsible for assuring coding guidelines and regulations are not compromised during the decision-making process related to clinical documentation and the coding of this documentation. This position partners with Clinical Documentation Nurses, Physicians, and other licensed providers to improve the quality of documentation, assuring best quality performance and representation of care provided. In addition, the Coding Quality Auditor and Specialist collaborates with the CMOs to ensure the integrity of the Health Record is established through best practices in Clinical Documentation and Coding.

The Coding Quality Auditor and Specialist is responsible for maintaining quality work queues and quality reports, advanced and complex project work that includes but, is not limited to, Risk Adjustment, Mortality Review, Hospital Acquired Condition (HAC) and Patient Safety Indicator (PSI) Review, Quality Abstraction and Analysis, and/or special and non-traditional project work. Incumbents to this role have a mastery of advanced clinical documentation integrity and quality concepts, coupled with the ability to consistently identify root causes and deliver measurable results. Key to this role is the ability to lead and facilitate quality initiatives and external rankings initiatives.

The Coding Quality Auditor and Specialist solves complex problems and adds new perspectives to existing solutions. The Coding Quality Auditor and Specialist applies advanced knowledge of the national quality agenda and clinical documentation integrity and coding compliance to advance problem analysis and creative process redesign for our client.

Responsibilities:

Collaborates with clinical documentation team in the review of inpatient accounts (with an emphasis on mortality reviews) identifying documentation improvement opportunities
Assess DRG, PDx, secondary Dx, PCS, POA and all other components of documentation that impact quality metrics
Consistently assures coding practices remain compliant with coding guidelines and regulations
Continually identifies educational opportunities related to coding and documentation
Expert educator to clinical teams, medical staff and inpatient coders
Identifies strategic plans that will result in a positive impact to the clinical dashboard
Develops clinical relationships across the health system securing interdepartmental support necessary for successful implementation of education strategies assuring achievement of overall strategic targets
Ability to multi-task a variety of audits
Ability to analyze data and construct appropriate action plans
Develops teaching tools to promote quality outcomes
Is an active member of clinical and executive meetings as identified
Advanced understanding of quality metrics for health system (Vizient, PSI, USNWR, LeapFrog, AHRQ, CMS)

Qualifications Required:

RHIT or RHIA or CCS Certification
Certified Clinical Documentation Specialist

(will consider CDIP certification)

Bachelor Degree – Healthcare related

(will consider candidate currently enrolled in Bachelor program)

Five years of coding experience in area of expertise
Clinical expertise and understanding achieved through prior experience working with clinical documentation teams
Excellent verbal, written, and presentation skills
Demonstrates critical thinking skills
Excellent interpersonal skills
Planning and time management skills
Educational/training experience

Preferred: