Job Title: Inpatient Medical Records Coding Auditor Department: Health Information Management Shift: 1st Full/Part: Type 1 (72-80 Hrs/PP) Specialty: Audit Job Number: 2014-0343 Job Description: Position Highlights: This position is responsible for continuous monitoring of the coding quality performed by staff both within and external to the Health Information Management Department. Provides educational programs to both physicians and coding personnel to improve coding quality. Prepares various reports for administration and the Compliance Council. Represents Health Information Management and RUMC at forums that are internal and external to the medical center. Position Responsibilities: Conducts ongoing quality and compliance reviews of coding throughout the Medical Center that impacts Hospital billing. Ensures all departmental coding policies/procedures/guidelines are current and followed. Manages documentation of the employee training process. Assists Director and Coding Manager in development of quality, performance and productivity standards for the Health Information Management Department, assist in ensuring all function/work is reviewed on a regular, ongoing basis and reported to Department Management. Provides periodic refreshers, updates, and orientations for staff to ensure compliance with Hospital and JCAHO requirements. In-services staff routinely on compliance issues. Ensures compliance by all coding and coding support staff with all applicable federal, state, local and accrediting agency regulations. Reports monthly, or more frequently, on achievement of/compliance with department goals. Demonstrates the ability to work as part of the management team. Demonstrates technical expertise on coding issues. Manages the resolution of all billing rejections due to coding issues. Participates in external auditor review process and billing corrections. Monitors various regulatory sources to keep HIM coding and management staff informed and trained on DRG coding rules, regulations, and related issues. Provides ICD-9-CM coding training to Registration staff and others as required. Through daily auditing, identifies coding-related DRG losses and variances as well as compliance-related issues. Monitors both Medicare and non-Medicare cases for coding accuracy. Prepares written reports to the Compliance Department and management as appropriate. Works closely with Patient Financial Services to resolve any claim denials related to coding performed by HIM staff. Assists in updating the charge master. Performs periodic claim reviews to check code transfer accuracy from the accuracy from the abstracting system through the billing system. Performs various tests to ensure system is functioning properly and all staff is trained on new functionalities as new updates to coding system are installed. Educates physician staff on documentation requirements to support DRGs and coding assigned to claims. Audits physician and non-physician (therapists, etc.) documentation in the record for completeness and timeliness periodically Participates on various Medical Center billing, coding and compliance related committees. Position Qualifications Include: RHIA or RHIT preferred, CCS credential required Bachelors of Science degree in a related field, Associates in Health Information Technology minimum acceptable. 5 or more years of inpatient coding experience highly desired Progressively responsible experience in Health Information Management with no less than 3 years as a Senior or Lead Coder Knowledge and experience in use of computer applications including abstracting and encoding software, DRG grouper software, MS office and hospital information systems. Understands QIO requirements and PEPP reporting. Ability to apply local, state, and federal guidelines with attention to detail. https://rush.igreentree/CSS_External/CSSPage_JobDetail.ASP?T=20140316033616&
Posted on: Sun, 16 Mar 2014 09:04:35 +0000
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