Coding Quality Auditor and Specialist

Medasource; Orlando (FL); Remote; USD 65,000 - 98,000; Full time

Job summary

A leading health service provider is seeking a Coding Quality Auditor and Specialist to ensure compliance with coding guidelines and enhance clinical documentation quality. This remote role requires expertise in coding and documentation, collaborating with clinical teams to improve metrics and outcomes. Ideal candidates will have significant coding experience and relevant certifications, exhibiting strong analytical and communication skills.

Qualifications

• RHIT or RHIA or CCS Certification required.
• Five years of coding experience in area of expertise.
• Excellent verbal, written, and presentation skills.

Responsibilities

• Collaborates with clinical documentation team in the review of inpatient accounts.
• Assesses DRG, PDx, secondary Dx, PCS during documentation.
• Identifies educational opportunities related to coding and documentation.

Skills

Critical thinking

Communication

Interpersonal skills

Planning and time management

Education

Bachelor Degree – Healthcare related

Master’s Degree in related field

Job description

1 day ago Be among the first 25 applicants

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:

• Master’s Degree in related field or currently enrolled in Master’s program

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  IT Services and IT Consulting

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