Lead HIM Hospital Coder/Auditor (In-Patient - Observation)

The University of Kansas Health System; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

The University of Kansas Health System seeks a Lead HIM Hospital Coder/Auditor (In-Patient/Observation) to ensure accurate DRG assignments via ICD-10-CM/PCS. This remote role collaborates with physicians, CDI, and support services to improve documentation and coding quality.

You will lead audits, provide coder education, and prepare reports for management. Strong inpatient/outpatient coding experience and Epic proficiency are preferred.

Qualifications

• Associate’s Degree in Health Information Management or related field.
• 5+ years of inpatient/outpatient ICD-10 CM/PCS coding experience.
• 1+ year of auditing experience in ICD-10 CM/PCS.
• RHIT, RHIA or CCS certification preferred.
• Epic experience is a plus.

Responsibilities

• Review all ICD-10-CM/PCS coding for DRG accuracy.
• Lead coding audits and provide coder education.
• Collaborate with CDI team to improve documentation and DRG assignment.
• Prepare auditing reports and present findings.
• Assist in training new hires and coders.

Skills

Coding ICD-10-CM/PCS

Auditing experience

Education & training

Communication with stakeholders

MS-DRG Knowledge

Education

Associate’s Degree in Health Information Management

5+ years inpatient/outpatient ICD-10 CM/PCS coding experience

1+ year auditing experience

Bachelor’s Degree in Health Information Management (preferred)

Tools

Epic experience

Job description

Position Title: Lead HIM Hospital Coder/Auditor (In-Patient - Observation) Remote

Position Summary / Career Interest: The Health Information Management (HIM) Inpatient/Observation Hospital Coder Auditor/Lead responsibilities include reviewing all diagnosis and procedural coding in ICD-10-CM/PCS for accurate DRG assignment. This position will have daily interactions with internal and external customers to include physicians, hospital support services and ancillary departments. The HIM Inpatient/Observation Hospital Coder Auditor/Lead will perform inpatient/outpatient coding compliance audits and provide coder education. This position will assist in the preparation and finalization of auditing reports.

Responsibilities and Essential Job Functions

• Monitors coding compliance and case mix comparison for select outpatient, same day surgery and inpatient accounts.
• Works in conjunction with the Clinical Documentation Improvement (CDI) team to provide comprehensive medical record documentation and achieve accurate DRG assignment and appropriate mortality and severity scores.
• Validates HIDI, KHA and other external data reporting accuracy, while obtaining target coding trends for improvement.
• Completes focused record reviews based on benchmarking data from UHC and other quality reports quarterly.
• Identifies unspecified diagnoses used and determines if documentation supports a more specific diagnosis.
• Works with Coding Supervisor/Manager on record review projects.
• Provides coding expertise for data reporting activities while employing all federal regulations and coding guidelines.
• Provides education/training to physicians and other providers on coding and DRG assignment.
• Reviews the complex (problematic coding that needs research and reference checking) medical records and accurately codes the primary/secondary diagnoses and procedures using ICD-10-CM/PCS coding conventions.
• Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM/PCS coding guidelines to inpatient and outpatient diagnoses and procedures.
• Provides high-level analysis of trends to Management, Revenue Managers and others about coding related issues.
• Researches and identifies trends in unbilled accounts.
• Coordinates quality reporting measures with providers, revenue managers and management.
• Assists supervisor in training new hires and other coders within the department.
• Performs audits on coding accuracy and/or DRG assignment to comply with corporate compliance responsibilities to include RAC and insurance revision requests and appeals.
• Prepares materials for presentation for continuing education to applicable internal and external customers.

Education and Experience

• Required: Associate’s Degree in Health Information Management or a related field of study from an accredited college or university.
• Required: 5 or more years of coding experience in inpatient and/or outpatient ICD-10 CM/PCS.
• Required: 1 or more years of auditing experience utilizing ICD-10 CM/PCS.
• Preferred: Bachelor’s Degree in Health Information Management or a related field of study from an accredited college or university.
• Preferred: 7 or more years of Epic experience.

Preferred Licensure and Certification

• RHIT, RHIA or CCS certification.

Language Skills

• Fluent English – must be able to read, write, and speak English.

Knowledge Requirements

• Expertise in MS-DRG Optimization, APR DRG, RAC/HAC/Core Measures.
• Coding accuracy: 95% or better in accordance with HIM Quality Analysis Policy.

Employment Type

Full time

Equal Opportunity Statement

The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. The health system provides reasonable accommodations to qualified individuals with disabilities. Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.

About The University of Kansas Health System

As part of the region’s premier academic medical center, The University of Kansas Health System in Kansas City is a world-class healthcare provider and destination for complex care and diagnosis. We are driven by our commitment to service, continuous improvement and to the highest degree of excellence. Collaboration between physicians, nurses, researchers, educators and other professionals who share their expertise leads to exciting discoveries and life-changing treatments for the people we serve.