Health Information Auditor

Saint Francis Hospital, Inc.; United States; Remote; USD 65,000 - 95,000; Full time

Job summary

Saint Francis Health System is seeking a Health Information Auditor to ensure coding data quality and regulatory compliance across coding teams. This role requires staying current with coding rules and collaborating with Patient Access and Patient Billing Services.

You will conduct monthly audits, focus on DRG accuracy, and guide education for coders while supporting documentation and regulatory reporting requirements.

Qualifications

• High School Diploma or GED required.
• CCS or CPC certification required; CPMA preferred.
• 8 years related experience in health information/coding.

Responsibilities

• Audits a percentage of coders' work monthly for accuracy and compliance.
• Audits DRGs to ensure regulatory compliance.
• Ensures timely submission of coded accounts affecting hospital reimbursement.
• Researches outstanding accounts and ensures completion.
• Assigns and monitors Educode modules for coder training.
• Trains and orients new coders to the team.
• Assists with physician queries for documentation.
• Reviews monthly POA reports and produces quality reports.
• Educates coders on LCDs and clinical coding guidelines.

Skills

Advanced coding knowledge

Interpersonal skills

Written and verbal communication

MS Office / data reporting

Education

High School Diploma or GED

Tools

Educode modules

Coding software

Job description

Full Time Days Monday-Friday Day-shift

Job Summary

The Health Information Auditor ensures that coding specialists are well- trained and up- to- date on rapidly changing regulatory requirements affecting coding compliance and hospital reimbursement. The auditor ensures coding data quality, accuracy and timeliness of submission to data repositories at the state, federal and hospital levels. The auditor must maintain an up- to- date knowledge of all coding rules and guidelines and serves as a liaison with Patient Access and Patient Billing Services. The auditor is responsible for ongoing and continuous monitoring of the quality of all coded data, performing monthly focused audits on all coders and ensuring that a 95% accuracy rate is maintained.

Minimum Education

High School Diploma or GED required.

Licensure, Registration and/or Certification

Certified Coding Specialist (CCS) required for facility coding or Certified Professional Coder (CPC) for professional coding. Certified Professional Medical Auditor (CPMA) preferred.

Work Experience

8 years related experience.

Knowledge, Skills and Abilities

Ability to utilize related software and computer/pc skills. Advanced knowledge of coding. Excellent interpersonal, written and oral skills. Ability to analyze data and produce reports using MS office.

Essential Functions and Responsibilities

• Audits randomly a % of each coders' work monthly, ensuring accuracy and compliance.
• Audits focus DRGs as determined by outcomes to ensure compliance with regulatory standards.
• Ensures timely submission of all coded accounts affecting hospital reimbursement.
• Researches outstanding accounts and works to ensure completion.
• Assigns and monitors Educode modules, ensuring that each coder completes assigned lessons.
• Trains and orients new coders to the team.
• Assists with physician queries for documentation.
• Reviews pertinent reports such as monthly POA and produces individual and cumulative monthly quality reports.
• Educates coders on LCD's, clinical coding guidelines and other regulatory guidelines.

Decision Making

Independent judgment in making decisions from many diversified alternatives that are subject to general review in final stages only.

Working Relationships

Coordinates activities of others (does not supervise). Leads others in same work performed (does not supervise). Has input on performance evaluations but does not prepare or give. Works directly with patients and/or customers. Works with internal/external customers.

Special Job Dimensions

None.

Supplemental Information

This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.

Health Information Ambulatory Coding - Yale Campus Location: Virtual Office, Oklahoma 73105

EOE Protected Veterans/Disability

About Saint Francis

Saint Francis is a Catholic, not-for-profit Health system based in Tulsa, Oklahoma. We are the largest private employer in Eastern Oklahoma with over 12,000 employees, including 1,000 physicians. The health system is anchored by the 1,112-bed Saint Francis Hospital, the largest hospital in Oklahoma and the 11th largest in the nation. Our system also includes hospitals in south Tulsa, Muskogee and Vinita, as well as 110 Warren Clinic locations from Monkey Island to McAlester, northeastern Oklahoma's only children's hospital, a level IV neonatal intensive care unit, a 168-bed heart hospital, and Tulsa's leading trauma and emergency center.