UF Health · 17 hours ago
HIM Coding Quality Auditor
Gainesville, FL
Full-time
Onsite
Senior Level
5+ years expUF Health is seeking a HIM Coding Quality Auditor responsible for the ongoing quality review and assessment of coded hospital data. The role involves performing audits on coding accuracy, managing audits, and contributing to educational opportunities for staff.
HealthcareHealth CareMedical
Responsibilities
Responsible for ongoing quality review and assessment of coded hospital data
Performs audits on the accuracy of ICD-10, CPT-4, MS-DRG, APR-DRG and APC assignments
Performs review of claims denied for coding, documentation, and clinical validation, and formulates and submits letters of appeal
Prepares reports for management review and identifies trends
Conducts focused retrospective audits and regular scheduled audits of individual coders
Manages all audits conducted by internal and external entities and responds to requests for code verification
In conjunction with the Coding Supervisors and Coding Manager, contributes to the development of educational and training opportunities for staff
Qualification
Required
One of the following credentials is required: Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Professional Coder–Hospital (CPC-H), or Registered Nurse (RN) with education and experiential training in Medical Coding, Utilization Review, Denial Management, Case Management, or related functions
Minimum of five (5) years of experience in hospital inpatient and/or outpatient medical record review, coding, and reimbursement required
Strong knowledge of ICD-9-CM, ICD-10-CM/PCS, CPT coding, and prospective payment systems required
Proficiency with Microsoft Windows operating systems and Microsoft Office applications, including Word, Excel, and PowerPoint, as well as coding/grouping software
Demonstrated ability to work with minimal supervision and function independently as a self-starter
Ability to communicate clearly and effectively, both verbally and in writing
Ability to generate reports for management review that present audit results in a clear and concise manner
Ability to meet deadlines and adapt to frequent regulatory changes
Ability to maintain positive and productive relationships with internal and external teams and customers
Preferred
AHIMA Certified ICD-10-CM/PCS Trainer designation
Coding audit experience
Company
UF Health
University of Florida Health is a world-class academic health center in Florida, encompassing hospitals, physician practices, colleges, centers, institutes, programs and services across northeast and north-central Florida.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Robert Thornton
Senior Vice President and Chief Financial Officer
Lydia Hendrix BSN,CRRN,MS
Chief Operating Officer
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