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Adventist Health · 1 month ago

Acute Coding Quality Review Auditor

Roseville, CA

Full-time

Onsite

Mid Level

3+ years exp

Adventist Health is a faith-based, nonprofit health system serving communities on the West Coast and Hawaii. The Acute Coding Quality Review Auditor will perform quality reviews and audits to ensure compliance with coding guidelines and contribute to improving departmental processes.

Elder CareHealth CareHospitalMedicalNon ProfitWellness

H1B Sponsor Likely

Responsibilities

Performs regularly scheduled quality reviews and audits per departmental policies and procedures (routine, pre-bill, policy driven, targeted, and post-bill) for hospital inpatient and/or outpatient coding

Facilitates the coder audit appeal process, providing rationale and education to the coding team as required

Performs ad hoc quality reviews, such as targeted DRG reviews, and special projects as assigned by management

Prepares detailed audit reports outlining findings, recommendations, rationale, and corrective actions needed

Facilitates the coder appeal process

Assists team members with coding questions and provide resolution guidance

Assists in ensuring coding staff adherence with coding guidelines and policy, both internal and vendor teams

Demonstrates and applies expert level knowledge of medical coding practices and concepts

Communicates appropriately with manager and all stakeholders as required

Identifies and communicates educational opportunities to manager

Maintains working knowledge of workflows, systems, and tools used in the department

Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current

Maintains up-to-date knowledge of medical terminology, coding guidelines, quality standards, regulatory changes, etc. that affect the audit process

Assists in creation and maintenance of a positive working environment, including effective communication and setting an appropriate professional example

Performs other job-related duties as assigned

Qualification

ICD-10/PCS codingCPT codingCoding auditingCertified Coding SpecialistProfessionalismEducationTrainingInterpersonal communicationOrganizational skills

Required

High School Education/GED or equivalent: Required

Three years' acute care inpatient and/or outpatient coding experience: Required

Certified Coding Specialist credential through AHIMA: Required

Preferred

Associate's/Technical Degree or equivalent combination of education/related experience: Preferred

Three years' coding auditing/monitoring experience: Preferred

Company

Adventist Health

Glassdoor3.7

Adventist Health is a Adventist Health is a not-for-profit health care organization .

Founded in 1980

Roseville, California, USA

10001+ employees

https://www.adventisthealth.org/

H1B Sponsorship

Adventist Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

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2022 (1)