Coding Quality Inpatient MS-DRG Auditor

HCA Healthcare; Savannah (GA); Remote; USD 60,000 - 100,000; Full time

Job summary

Join a forward-thinking organization as a Coding Quality Inpatient MS-DRG Auditor, where your expertise in medical coding and quality assessment will play a vital role in ensuring compliance and data integrity. This exciting position allows you to lead and coordinate quality reviews, impacting patient care and reimbursement accuracy. With a commitment to investing in your success, this innovative company offers a supportive environment that values your contributions. If you have a passion for coding and a desire to make a difference, this opportunity is perfect for you. Become part of a dedicated team that strives for excellence in healthcare.

Benefits

Comprehensive Medical Coverage

401(k) Plan with 100% Match

Employee Stock Purchase Plan

Education Assistance

Paid Time Off

Free Counseling Services

Flexible Spending Accounts

Referral Services

Consumer Discounts

Family Support Benefits

Qualifications

• 5+ years of acute care inpatient and outpatient coding experience required.
• Expert level knowledge of medical coding practices and concepts.

Responsibilities

• Lead quality reviews for inpatient and outpatient coding across multiple HSCs.
• Ensure adherence to coding guidelines and maintain productivity standards.

Skills

Medical Coding Practices

Quality Assessment Reviews

Data Integrity

Compliance with National Coding Guidelines

Education

Undergraduate degree in HIM/HIT

Tools

Coding Software

Job description

Description

Introduction

Do you want to join an organization that invests in you as a Coding Quality Inpatient MS-DRG Auditor? At Work from Home, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years.

Must have DRG Validation/Auditing Experience

Benefits

Work from Home offers a total rewards package that supports the health, life, career, and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance, and more.
• Free counseling services and resources for emotional, physical, and financial wellbeing.
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service).
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock.
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder, and pet care, home and auto repair, event planning, and more.
• Consumer discounts through Abenity and Consumer Discounts.
• Retirement readiness, rollover assistance services, and preferred banking partnerships.
• Education assistance (tuition, student loan, certification support, dependent scholarships).
• Colleague recognition program.
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence).
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients’ lives, and you have the opportunity to make a difference. We are looking for a dedicated Coding Quality Inpatient MS-DRG Auditor like you to be a part of our team.

Job Summary and Qualifications

As a Coding Quality Inpatient MS-DRG Auditor, you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies, and the Company coding policies for complete, accurate, and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes communicated to the HSC team to improve the accuracy, integrity, and quality of patient data, to ensure minimal variation in coding practices, and to improve the quality of physician documentation within the body of the medical record to support code assignments.

What you will do in this role:

• Lead, coordinate, and perform all functions of quality reviews (routine, pre-bill, policy-driven, and incentive plan-driven) for inpatient and/or outpatient coding across multiple HSCs.
• Assist in ensuring HSC coding staff adherence with coding guidelines and policy.
• Demonstrate and apply expert level knowledge of medical coding practices and concepts.
• Participate in special reviews or projects.
• Maintain or exceed 95% productivity standards.
• Maintain or exceed 95% accuracy.
• Meet all educational requirements as stated in current Company policy.
• Review all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current.

What qualifications you will need:

• Undergraduate degree in HIM/HIT preferred (Associates or Bachelors).
• Minimum of 5 years acute care inpatient and outpatient coding experience required.
• Minimum of 3 years coding auditing/monitoring experience strongly preferred.
• RHIA, RHIT and/or CCS preferred.

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll, and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers, and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are a family of 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Coding Quality Reviewer opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.