Experienced Coder Opportunity! Clinical Data Quality Auditor and Educator (Remote)

Virtua; United States; Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a dedicated coding professional to ensure high standards in hospital coding practices. This role involves overseeing coding quality, conducting audits, and providing essential training to coders while collaborating with various departments to address coding and reimbursement issues. The ideal candidate will possess extensive experience in inpatient and outpatient coding, along with a strong background in coding compliance. Join a forward-thinking organization committed to delivering exceptional healthcare and making a difference in the community through your expertise.

Qualifications

• 3+ years of hospital coding experience required.
• Expertise in ICD-10-CM/PCS and CPT coding essential.
• Ability to develop training materials and deliver presentations.

Responsibilities

• Oversee coding quality and standards development for various codes.
• Conduct audits and provide training for coding staff.
• Collaborate with departments to resolve coding issues.

Skills

Inpatient Coding

Outpatient Coding

Training Development

ICD-10-CM/PCS

CPT Coding

Auditing Skills

Interdepartmental Communication

Education

Bachelor’s Degree in HIM

Coding Certificate

RHIA/RHIT Certification

Tools

Microsoft Office

Encoder Tools

Job description

At Virtua Health, we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between - we are your partner in health devoted to building a healthier community.

If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment.

In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics.

Location:

100% Remote. Currently Virtua welcomes candidates for 100% remote positions from: AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV only.

Employment Details:

• Type: Employee
• Classification: Regular
• Time Type: Full time
• Work Shift: 1st Shift (United States of America)
• Total Weekly Hours: 40

Key Requirements:

• Occasional travel to South Jersey
• Experience in inpatient and outpatient coding
• Ability to develop training materials for the coding team

Job Summary:

Responsible for hospital coding quality and standards development for ICD-10-CM/PCS, CPT, and HCPCS codes. Includes performing internal audits, overseeing external audits, and providing education and training to hospital coders. Collaborates with hospital departments to resolve coding issues and develops compliance plans for hospital coding and abstracting. Participates in system administration and maintenance for coding software.

Position Responsibilities:

Training and Education:

Provide training for new coders, develop coding resources, and assist in coordinating coding and CDI team activities. Educate staff on coding guidelines and monitor productivity and quality standards.

Interdepartmental Issue Resolution:

Work with various hospital departments to resolve coding and reimbursement issues, serve as escalation point, and educate staff including physicians on coding requirements. Recommend policy and procedure updates.

Auditing:

Conduct audits to monitor quality and compliance, handle external audits, and respond to payor audits. Provide feedback and improvement recommendations.

Accounts Receivable:

Monitor billing reports, troubleshoot account issues, and assist with coding to support A/R goals. Collaborate with campuses to optimize workflow.

Policies and Procedures:

Develop and enforce policies related to coding, data abstraction, and compliance. Maintain documentation and provide feedback to management.

System Maintenance:

Maintain and update coding and abstracting systems, support system upgrades, and manage downtime procedures.

Qualifications:

• Minimum 3 years hospital inpatient and outpatient coding experience
• Experience with multiple service lines preferred
• Knowledge of PC applications, Microsoft Office, and encoder tools
• Expertise in ICD-10-CM/PCS, CPT-4, DRGs, APCs, and CMI
• Ability to develop and deliver educational presentations

Education & Certifications:

• Bachelor’s or Associate’s Degree in HIM, Coding Certificate, or equivalent experience leading to certification
• Certification as CCS by AHIMA required
• RHIA/RHIT preferred