Divisional Coding Quality Auditor-Educator-Remote

Divisional Coding Quality Auditor-Educator-Remote Altamonte Springs, FL

AdventHealth Corporate

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• Job Schedule: Full-time
• Pay Range: $35.82 - $53.73
• Job ID: 24043032
• Job Family: Health Information Management
• Shift: 1 - Day
  
  

Hospitals, medical centers and facilities need more than physicians, nurses and specialists delivering care to our patients. A truly successful health care organization needs a thoughtful, dedicated, steady and experienced team working behind the scenes to make sure communities around the country receive the health care they need.

If you’ve also been interested in working in the health care field but aren’t a health care provider, a corporate career at AdventHealth may just be the perfect fit. We’re a faith-based health care organization headquartered in Altamonte Springs, Florida. As a national leader in quality, safety and patient satisfaction, our 92,000 team members maintain a long tradition of whole-person health by caring for the physical, emotional and spiritual needs of every patient.

Start your journey with a health care career at AdventHealth Corporate.

Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we’re committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.

All the benefits and perks you need for you and your family:

• Benefits from Day One
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support
  
  

Job Location : Monday-Friday Remote

The Role You’ll Contribute

The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the inpatient or outpatient coding teams across the organization by completing both overall and account-level quality reviews of inpatient and outpatient coding functions. Quality audits are inclusive of assessing staff adherence to inpatient or outpatient coding policies, procedures, and guidelines established by corporate leadership. The Corporate QA is responsible for initial audits during the coder onboarding process for assigned staff, as well as supporting on-going quality assurance needs for coding staff. They will review medical records and documentation for coding accuracy, providing feedback, and delivering additional education to correct inaccurate coding, equipping staff with the knowledge and skills required to achieve industry best practice levels of performance. The Corporate Quality Auditor will adhere to AdventHealth Corporate Compliance standards, as well as rules and regulations of all applicable local, state, and federal agencies and accrediting bodies.

Completes timely and accurate quality assurance audits while adhering to inpatient and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into practical recommendations for improvements in further standardizing audit policies and procedures actionable recommendations for improvement.

The Value You’ll Bring To The Team

• 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
• Will provide 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.
• May participate in Iodine Retrospect inpatient reviews in partnership with CDI.
• Provides feedback on the application of coding guidelines, practices, and proper documentation techniques, and data quality improvements.
• Provides input on which quality audit and metrics will be tracked and visualized on shared dashboards to report outcomes and improve processes and workflows including programming requests, process changes, and staff accuracy and efficiencies
• Serves as point person for regional HIM/Coding teams to support quality audits and develop/ maintain reports, scorecards and dashboards that effectively tell the story of the data and highlight education opportunities in a manner that is easily understood and acted upon
• Flags data or analytics limitations, employs critical thinking and creative problem solving to address barriers, and escalates issues to leadership when appropriate
• Documents and presents findings and trends from the quality audits to the HIM/Coding leadership
• Reports any compliance and/or risk issues to the compliance department. Provides suggestions on process improvement.
• Works with the audit team and coding manager to develop meaningful education and may conduct educational huddles for inpatient coders across the organization.
• Makes recommendations to corporate coding leaders for coding policy/guideline changes, based on trending quality issues
• Works with Epic and AIT to identify automation and system enhancements as they pertain to coding.
• Performs other duties as assigned.
  
  

Qualifications

The expertise and experiences you’ll need to succeed:

Knowledge And Skills Required

• Thorough understanding of coding processes and workflows
• Expert level knowledge of disease pathophysiology and drug utilization
• Expert level knowledge of Medicare Severity Diagnosis-Related Groups (MS-DRG), and All Patient Refined Diagnosis-Related Groups (APR DRG), NCCI policy, OCE Edits, APCs.
• 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 (as needed to perform duties)
• Proficient in MS Office (Word, Excel, PowerPoint, Visio, Outlook, etc.) and familiarity with database programs
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient manner
• Ability to communicate professionally and effectively in English, both verbally and in written form
• Ability to follow complex instructions and procedures, with close attention to detail
  
  

Knowledge And Experience Preferred

• Epic experience
  
  

Education And Experience Required

• Five (5) years of inpatient or outpatient coding or Coding Quality Auditor experience
• Completion of a coding certificate program or associate degree in HIM field
  
  

Licensure, Certification Or Registration Required

• Certified Coding Specialist
• Certified Professional Coder
• Certified Professional Coder Payer
• Registered Health Information Administrator
• Registered Health Information Technician
  
  

Licensure, Certification Or Registration

Please be advised that all licenses and certifications listed are not required. If you only have one or some of those listed, you may still be eligible for this position.

• Certified Coding Specialist
• Certified Professional Coder
• Certified Professional Coder Payer
• Registered Health Information Administrator
• Registered Health Information Technician
  
  

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Health Information Management

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day

Req ID: 24043032

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.

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Apply Now

Internal Employees Apply Here

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Our Promise To You

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.