Outpatient Coding Quality Audit Coordinator

BJC HealthCare; Missouri; Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Comprehensive medical, dental, vision,

life insurance

401(k) with match

Tuition Assistance available

Paid Time Off benefit

Adoption assistance

Job summary

BJC HealthCare is seeking an Outpatient Coding Quality Auditor to support second level audits and real-time education within our Coding Department. This remote role targets candidates with 2-5 years of outpatient coding experience in a hospital setting and professional certifications.

You will analyze auditing results, develop educational materials, and collaborate with Compliance, Revenue Management, and providers to improve coding accuracy and reimbursement quality across our system.

Qualifications

• 2–5 years of outpatient coding experience in a hospital setting.
• Must hold one of the following certifications: RHIT, CCS, CPC, or RHIA.
• Remote position with remote-eligible states listed in the job post.

Responsibilities

• Serves as subject matter and decision support for Enterprise Coding and supports issue resolution.
• Develops and delivers focused coding education and training to address at-risk areas.
• Completes timely quality assurance audits in accordance with OPPS using ICD-10-CM and CPT/HCPCS.
• Builds collaborative relationships with Quality, Compliance, Revenue Management, and providers.

Skills

Outpatient coding experience

Hospital environment experience

Education

High School Diploma or GED

Associate's Degree

Bachelor's Degree

Job description

Additional Information About the Role

BJC is hiring for a Coding Quality Audit Outpatient Coordinator. We are looking for 2-5 years of Outpatient Coding in a hospital environment. Must have one of the following certifications:

• RHIT, CCS or CPC, RHIA

Remote position.

Remote eligible states:

• Alabama
• Iowa
• North Carolina
• Arkansas
• Kansas
• Ohio
• Florida
• Kentucky
• Oklahoma
• Georgia
• Louisiana
• South Carolina
• Illinois
• Mississippi
• Tennessee
• Texas
• Indiana
• Missouri
• Wisconsin

Overview

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.

BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.

Preferred Qualifications

Role Purpose

The Outpatient Coding Quality Auditor is responsible for second level coding audits and real time education supporting the on-going quality assurance activities for the Coding Department. Quality audits are inclusive of assessing compliance with federal and state regulatory coding guidelines, focusing on appropriate assignment of all diagnoses, procedures and modifiers to ensure accurate coding for reimbursement and clinical services (Quality Measures). Coding auditing and education encompasses all the Outpatient services of our large health system including critical access, community and Academic hospitals (pediatric and adult). Audit findings are analyzed to identify risk areas and develop educational materials. Educational materials may include individualized coder development plans, regulatory updates, or for cause education to support BJC as a best-in-class organization.

Responsibilities

• Serves as subject matter and decision support experts for Enterprise Coding. Actively participates in committees, project teams and other meetings to support issue resolution, process improvement and process development. Proactively identifies issues or trends and reports to Coding Leadership as appropriate.
• Develops and delivers focused coding education, training plans and tools to address areas at risk, regulatory updates, and continuous opportunities for improving coding and compliance outcomes.
• Completes timely and accurate quality assurance coding audits in accordance with OPPS using ICD-10-CM and CPT/HCPCS Coding Classification Systems. Adheres to federal and state regulatory and payer guidelines. Translates quality auditing results into practical and actionable recommendations for improvements in further standardizing audit policies and procedures.
• Builds and maintains collaborative relationships intradepartmentally as well as with Quality, Compliance, Revenue Management, providers and other departments as appropriate.

Minimum Requirements

Education

• High School Diploma or GED

Experience

• 2-5 years

Supervisor Experience

• No Experience

Licenses & Certifications

• Certified Outpatient Coder
• RHIT, CCS or CPC
• Registered Health Info Admin

Preferred Requirements

Education

• Associate's Degree
• Bachelor's Degree

Experience

• 5-10 years

Benefits and Legal Statement

BJC Total Rewards

At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance* paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

To learn more, go to our Benefits Summary.

*Not all benefits apply to all jobs

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer