Inpatient Coding Auditor and Educator - HIM Department - Remote Work Schedule

The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partnership with the more than 171,000 Alaska Native and American Indian people that we serve and the Tribal health organizations of the Alaska Tribal Health System, ANTHC provides world-class health services, which include comprehensive medical services at the Alaska Native Medical Center, wellness programs, disease research and prevention, rural provider training and rural water and sanitation systems construction.

ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,100 employees offering an array of health services to people around the nation’s largest state.

Our vision: Alaska Native people are the healthiest people in the world.

ANTHC offers a competitive and comprehensive Benefits Package for all Benefit Eligible Employees, which includes:

• Medical Insurance provided through the Federal Employee Health Benefits Program as a Tribal Employee, with over 20 plans and tiers.

• Cost-Share Dental and Vision Insurances

• Discounted Pet Insurance

• Retirement Contributions with Pre-Tax or Roth options into a 403(b).

• 401(a) ANTHC Retirement Plan: After one year of employment, ANTHC will begin making matching contributions of up to 5% of your eligible pay, based on your own contributions. In addition, you may be eligible for an annual discretionary contribution of up to 3% from the employer.

• Paid Time Off starts immediately, earning up to 6 hours per pay period, with paid time off accruals increasing based on years of service.

• Eleven Paid Holidays

• Paid Parental Leave or miscarriage/stillbirth eligibility after six months of employment

• Basic Short/Long Term Disability premiums, Accidental Death and Dismemberment (AD&D) Insurance, and Basic Life Insurance are covered 100% by ANTHC, with additional options for Short-Term Disability Buy-Up Coverage and Voluntary Life for yourself and your family members.

• Flexible Spending Accounts for Healthcare and Dependent Care.

• Ancillary Cash Benefits for accident, hospital indemnity, and critical illness.

• On-Site Child Care Facility with expert-designed classrooms for early child development and preschool.

• Employee Assistance Program with support for grief, financial counseling, mental/emotional health, and discounted legal advice.

• Tuition Discounts for you and your eligible dependents at Alaska Pacific University.

• On-Site Training Courses and Professional Development Opportunities.

• License and certification reimbursements and occupational insurance for medical staff.

• Gym Access to Alaska Pacific University includes a salt water pool, rock climbing, workout gym, and steep discounts for outdoor equipment rentals.

• Emergency Travel Assistance

• Education Assistance or Education leave eligibility

• Discount program for travel, gym memberships, amusement parks, and more.

Alaska Native Tribal Health Consortium has a hiring preference for qualified Alaska Native and American Indian applicants pursuant to P.L. 93-638 Indian Self Determination Act.

Summary:

Under limited guidance, works in conjunction with providers, Coding Professionals, Utilization Review, Compliance, Health Information Management (HIM) and other health team members to provide overall coding quality, auditing and education services.

Responsibilities:

Serves as an expert in inpatient prospective payment system, MS-DRG’s, and tribal health regulations. Audits accounts utilizing coding resources to ensure accuracy of ICD-10-CM/PCS codes, CPT codes, Present on Admission (POA), Severity of Illness (SOI) and Risk of Mortality (ROM) is captured at highest level of specificity for assigned accounts. Reviews facility and/or professional codes selected.

Responsible for conducting concurrent and retrospective quality assurance reviews to ensure accuracy and compliance with medical coding and billing rules and regulations. Reviews quality of medical record documentation needed for accurate coding and works with providers to ensure diagnosis capture is specified. Prepares reports, identifies trends, and take appropriate action in response to results. Partners with Coding and CDI leadership in developing education for coders, clinical departments, and physicians for documentation improvement initiatives for all ANTHC departments.

Develop audit detail summary and reports to address any coding, documentation, or financial impact opportunities. Ensures abstracting functions are correctly captured. Uses technology to help determine areas of focus/need. Helps to prioritize areas of focus and develops and delivers presentations, creates and distributes tip sheets, newsletters, and other educational content. Uses trends and themes across services to build robust education for providers and coders. Maintain at least 95% accuracy rate at all times. Maintain productivity standards as set by the department. Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adhere to official coding guidelines. Performs other duties as assigned.

Other information:

Knowledge, Skills, Abilities:

• Knowledge of clinical application, medical terminology and abbreviations; anatomy and physiology; major disease process and pharmacology.
• Knowledge of classification systems ICD, CPT, and HCPCS nomenclature, coding rules and guidelines.
• Knowledge of coding conventions and rules established by the American Medical Association (AMA), the Center for Medicare and Medicaid (CMS), AHIMA, ACDIS, and other nationally recognized organizations for assignment of diagnostic and procedural codes.
• Knowledge of Alaska Tribal Health System, ANTHC, and Alaska Native culture.
• Knowledge of the Privacy Act of 1974 and HIPAA Privacy Rule Act of 1996.
• Knowledge of auditing principles and standards.
• Skill in operating a personal computer utilizing a variety of applications.
• Skill in developing and conducting training/educational sessions for diverse audiences.
• Skill in reading and auditing medical records, utilizing the electronic health record, and identifying documentation improvement opportunities.
• Skill in understanding medical billing procedures and protocols.
• Skill in receiving, disseminating information, effectively and appropriately; using analytical and research skills to define and solve problems.
• Skill in interpreting and applying ethical coding compliance, standards, federal and state laws and regulations; rules; policies and procedures; appropriate codes to diagnosis, procedures, evaluation and management, and supplies.
• Skill in oral, written communication, and writing technical reports and other materials for presentation.
• Skill in managing multiple priorities and tasks concurrently and meeting deadlines.
• Skill in establishing and maintaining cooperative working relationships with others.
• Ability to proficiently work with the electronic health records and abstract and enter data into all databases used for clinical documentation.
• Ability to establish and maintain cooperative working relationships with others.
• Ability to manage multiple priorities and tasks concurrently and meet deadlines.
Ability to communicate effectively.

MINIMUM EDUCATION QUALIFICATION

Associate’s degree in Health Information Technology/Management and a Certificate program in coding completed.

MINIMUM EXPERIENCE QUALIFICATION

Non-supervisory – Four (4) years of coding experience including hospital and professional services. An equivalent combination of relevant education and/or training may be substituted for experience.

Must possess at least 1 of the following:

• Certified Professional Coder (CPC)
• Certified Coding Specialist (CCS)
• Registered Health Information Technician (RHIT)
• Registered Health Information Associate (RHIA)

ADDITIONAL REQUIREMENTS

• May be required to work outside the traditional work schedule.
• May be called out to work off-shift in emergency situations.
• According to the needs of the organization, some incumbents in this job class may be required to obtain specific technical certifications and programming language skills.