Coding Quality Auditor, HB Coding

Medasource; Rockford (IL); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading company in healthcare is seeking a Coding Quality Auditor and Specialist to join their remote team. This role requires expertise in clinical documentation and coding, aiming to enhance quality metrics within the health system. The ideal candidate should hold relevant certifications, possess substantial coding experience, and demonstrate strong analytical and communication skills to effectively collaborate with clinical teams.

Qualifications

• Five years of coding experience in area of expertise.
• RHIT or RHIA or CCS Certification required.
• Certified Clinical Documentation Specialist (CDS or CDIP certification) required.

Responsibilities

• Collaborates with clinical documentation team to identify improvement opportunities.
• Assures coding practices comply with regulations.
• Identifies educational opportunities related to coding.

Skills

Critical thinking

Interpersonal skills

Planning and time management

Educational / training experience

Communication skills

Education

Bachelor Degree – Healthcare related

Master’s Degree in a related field

Job description

Title : Coding Quality Auditor and Specialist, HB Coding

Duration : Full Time Employment - direct hire with client

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

MUST RESIDE IN ONE OF THE FOLLOWING STATES TO BE CONSIDERED :

llinois, Wisconsin, Iowa, Missouri, Florida, and Indiana

Start Date : ASAP

Do you have the following skills, experience and drive to succeed in this role Find out below.

Job Description :

The Coding Quality Auditor and Specialist, HB Coding reflects the mission, vision, and values of the client, 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 the cleint's Health System.

The Coding Quality Auditor and Specialist is responsible for assuring that 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 the best quality performance and representation of care provided. In addition, the Coding Quality Auditor and Specialist collaborate 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 the cleint.

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 (CDS or 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 a related field or currently enrolled in a Master’s program