Coding Compliance Educator and Auditor – Hospitals - Remote
United States
As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed in the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
JOB SUMMARY
Develops inpatient coding educational courses and quizzes, including presenting live educational sessions, facilitating live Q&A calls, and recording audio for education. Researches complex inpatient coding issues. Conducts ad hoc audits of inpatient encounters to validate code assignment in compliance with the official coding guidelines as supported by clinical documentation in health record.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Develops inpatient coding education via PowerPoint and Articulate education software.
- Researches complex inpatient coding issues related to questions, inquiries, and investigations.
- Understands, interprets, and applies coding guidelines for risk-based audits and ad hoc audits. Audits inpatient diagnoses, procedural code assignments, and DRGs. Reviews accounts to validate submitted codes and abstracted data including, but not limited to ICD-10-CM codes and PCS codes, which impact reimbursement. .
- 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.
- Identifies documentation issues (lacking documentation, missed physician queries, etc.) that impact coding accuracy. Clearly communicates (verbally and in written reports or summaries) opportunities for documentation improvement related to coding issues.
- Stays current with AHA Official Coding and Reporting Guidelines, CMS, and other agency directives for ICD-10-CM and PCS coding. Completes online education courses and attends mandatory coding workshops and/or seminars (IPPS and ICD-10-CM/PCS updates) for inpatient coding. Reviews AHA quarterly coding update publications and biannual coding guideline updates. Attends all internal conference calls for Quarterly Coding Updates.
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of …
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401k with up to 6% employer match Career advancement opportunities Competitive benefits package Dental Disability Employee assistance Employee Assistance Program Employee Discount Program Flexible Spending Accounts Health Savings Accounts Life Insurance Medical Paid holidays Paid leave in accordance with Colorado’s Healthy Families and Workplaces Act Paid Time Off Vision Voluntary benefits
Tasks- Conduct audits
- Leadership
- Reporting
AHIMA Articulate Audit Auditing Clinical Documentation Coding Coding accuracy Coding education Compliance Computer Documentation Documentation improvement DRG DRG classification Healthcare industry expertise ICD-10 ICD-10-CM Inpatient Coding Interpersonal Leadership Medical terminology MS Office Pcs Physician queries PowerPoint Quality review Reimbursement Time Management
Experience3 years
EducationAssociates Business Equivalent Medical Terminology RHIA
Certifications TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9