Divisional Coding Quality Auditor & Educator

Texas Health Huguley FWS; Town of Florida (NY); On-site; USD 70,000 - 90,000; Full time

Job summary

A healthcare organization is seeking a Divisional Coding Quality Auditor & Educator responsible for ensuring coding accuracy in both inpatient and outpatient settings. The candidate should have over 5 years of coding experience and a solid understanding of coding guidelines. Responsibilities include conducting quality reviews and providing feedback to the coding team. This is an opportunity to contribute to healthcare quality assurance in New York.

Qualifications

• 5+ years experience coding acute care hospital charts.
• Expert level knowledge of coding guidelines and methodologies.
• Understanding of HIPAA privacy rules for patient information.

Responsibilities

• Complete timely and accurate quality assurance audits.
• Monitor coding principles and update based on industry trends.
• Provide feedback and education to coding staff.

Skills

Coding processes and workflows

Medical terminology

HIPAA privacy rules

Disease pathophysiology knowledge

Auditing skills

Education

Coding certificate program

Associate in HIM field

Job description

Job Description - Divisional Coding Quality Auditor & Educator

Divisional Coding Quality Auditor & Educator (Job Number: 25038837)

Job Summary

The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator is responsible for supporting the operations of the inpatient or outpatient coding teams by completing overall and account-level quality reviews of coding functions.

This position assesses staff adherence to coding policies, procedures, and guidelines and regulatory guidance. The role conducts initial audits during the coder onboarding process and supports ongoing quality assurance needs for coding staff.

The Corporate Quality Auditor/Educator reviews medical records and documentation for coding accuracy, providing feedback and additional education to correct inaccuracies.

Responsibilities

• Completes timely and accurate quality assurance audits while adhering to inpatient and/or outpatient coding policies, procedures, and established audit schedule.
• Uses relevant references to perform audits, including but not limited to: International Classification of Diseases, Clinical Modification (ICD-10-CM and ICD-10-PCS), CPT, ICD-10-CM/PCS Coding Conventions, Official Coding Guidelines, CPT Assistant, AHA Coding Clinic, CMS guidelines, NCCI guidance, etc.
• Provides outcomes of coding quality audit reviews with leadership.
• Maintains current knowledge of coding principles and guidelines as coding conventions are updated; monitors and analyzes current industry trends and issues for potential organizational impact.
• Assists with the facilitation of scheduled external audits.
• Responds to inpatient or outpatient coding questions from assigned coders/providers and provides official inpatient coding references and guidelines.
• Creates clear and accurate audit findings and recommendations in written audit reports that will be used for advising and educating coders, auditors, managers, and directors throughout the organization.
• Provides feedback to coding and CDI team members on escalated accounts.
• Collaborates with providers, AH Clinical, CDI, inpatient and outpatient coding staff to assist with or resolve issues relating to medical record documentation and coding.

Qualifications

• Completion of a coding certificate program.
• 5+ years experience coding acute care hospital chart.
• Thorough understanding of coding processes and workflows.
• Expert level knowledge of disease pathophysiology and drug utilization.
• Expert level knowledge of Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI), and Hierarchical Condition Categories (HCC).
• Expert level knowledge of medical terminology, coding guidelines and methodologies.
• Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature.

Preferred Qualifications

• 5+ years of inpatient or outpatient coding or Coding Quality Auditor experience.
• Associate in HIM field preferred.

Equal Employment Opportunity

AdventHealth is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, or any other characteristic protected by law.