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WVU Medicine · 4 days ago

WVUHS - Professional Coding Auditor- Educator (Urology/Neurology/Gastroenterology)

Carson City, NV

Full-time

Onsite

Senior Level

5+ years exp

WVU Medicine is a healthcare organization looking for a Professional Coding Auditor- Educator. The role involves educating and training coding staff, overseeing auditing and education plans, and ensuring accurate coding practices using various coding classifications.

Health CareHospitalMedical

Responsibilities

Manages activities of designated coding personnel in training for WVU Healthcare and assures the monitoring and reporting of respective employee’s developmental activity

Manages quality improvement audits and training of designated coding staff

Acts as expert coding resource not only to coders, clinical documentation improvement, providers and revenue cycle, but also to specialty groups and meetings

Acts as Super user for all Coding-related Electronic Medical Record Systems necessary for complete an accurate coding and EMR Data Governance. Updates policies and procedures for those areas of responsibility. In-services appropriate staff regarding changes in these areas

Develops and maintains coding related policies, procedures, query development, work queues and training materials in conjunction with management

Continually communicates with Coding Staff, Medical Staff, Physician Advisor, Department Chairman, and Department Administrators

Organizes, facilitates, performs, tracks, trends, and reports on internal quality reviews

Designs and uses audit tools (i.e ROC) to monitor the accuracy of coding, documentation gaps, and billing performed by Coding Specialists

Coordinates audits performed by outside agencies by obtaining accounts to be reviewed, acting as a liaison between agency and HIM personnel to gather data to be reviewed, facilitating exit conferences with Coding Specialists, and providing final reports to Coding Manager. (Includes, but not limited to, HIA quarterly audits, ROC Compass audits, etc.)

Coordinates coding/documentation denial reviews and facilitates appeal letter formation. Includes, but not limited to, RAC denials, insurance/3rd party payor denials, etc

Communicates regularly with the Coding Leadership on activities, problems, coding and/or documentation issues and pending audits

Ensures audit (external and internal) recommendations are completed (i.e. coding education, coding changes, rebills)

Extracts and analyzes from various sources then develops action plan when necessary

Assist with on-boarding of new Coding Specialists in regard to coding/quality related policies, audits and initiatives

Updates Coding Specialists on compliance and other regulatory changes

Keeps abreast of coding changes, state and federal regulations and coding resources (i.e. Coding Clinic)

If needed this position could be responsible for development and design of the curriculum for the WVU Healthcare Coding Certificate Program, as well as other special projects regarding the overall Data Governance of the EMR to enhance coding. Utilizes all necessary systems as part of curriculum and educational courses and administers exams. Involvement with testing and installation of system upgrades when necessary to assure curriculum is up-to-date

Qualification

ICD-10-CMCPTMS-DRG assignmentCertified Professional Coder (CPC)Health Information TechnologyAuditing techniquesMedical terminologyAnalytical skillsCommunication skillsOrganizational skillsTime managementMentoring skillsProblem solving skills

Required

Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience

Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience

High School Diploma or Equivalent AND Eight (8) years of coding experience

Certification in ONE of the following: Registered Health Information Administrator (RHIA) OR Registered Health Information Technician (RHIT) through American Health Information Management Association) OR Certified Outpatient Coder (COC) through American Academy of Professional Coders OR Certified Coding Specialist (CCS) through American Health Information Management Association OR Certified Professional Coder (CPC) through American Academy of Professional Coders

Must possess excellent written and verbal communication skills, as well as interpersonal skills necessary to communicate effectively

Must possess the knowledge of related provider healthcare compliance, revenue cycle operations, and auditing techniques required

Must possess the ability to mentor, educate and train others

Must ensure quality and productivity standards

Must be able to handle high stress and critical situations in a calm and professional manner

Must be able to concentrate and maintain accuracy during constant interruptions

Must possess independent decision-making ability

Must possess the ability to prioritize job duties

Must be able to adapt to changes in the workplace and work assignments

Must possess organizational and time management skills

Must possess the knowledge of anatomy, physiology and medical terminology

Must possess analytical and problem solving skills

Must be proficient in office software programs, including medical record and billing systems

Must possess the ability to analyze complex data and reports

Preferred

Bachelor's degree in Health Information Management or related field

Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the 'Teaching Physician Guidelines' for Professional Coding Positions preferred

Previous supervisory or project management experience