The Coding Auditor/Educator will ensure the accuracy and integrity of ICD-10-CM, CPT and DRG, and risk-adjustment factor assignment for the purpose of maintaining compliance with Federal and State Regulations and Compliance Guidelines. The Coding Coordinator will review charts on a monthly basis and maintain and educational plan for each coder. The Coding Coordinator/Validator conducts Coding Audits and calculates coder accuracy rates for the Outpatient Coder Levels I-III or Inpatient Levels Coder I -- III levels.
The Coding Auditor/Educator Provides 100% review of all Medical Records for newly hired coders and for performance management cases.
The Coding Auditor/Educator will review quarterly, the PEPPER report to analyze outliers, conduct reviews on those targeted/focused areas as identified on the report. The Coding Coordinator/Validator will perform reviews on any external review referrals.
The Coding Auditor/Educator will work closely with management to provide the status of reviews and propose topics for coding and clinical documentation improvement opportunity/education needed.
Maintains query tracking tool. Provides feedback to the management staff for improvement and status of queries.
This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to teamwork and cooperation.
QUALIFICATIONS
EDUCATION: High School Diploma required. RHIA or RHIT degree preferred in addition to the CCS or CPC-H
LICENSE/CERTIFICATION: at least one of the following required: CPC-H OR CCS
EXPERIENCE: 7 years acute health care experience required. Excellent coding skills with direct experience in ICD-10, DRG system, data analysis and reporting, and a strong working knowledge of disease processes and clinical medicine are required. Excellent computer skills required, including use of 3M encoder, coding references, acute care abstracting and reporting applications, and Microsoft Office required. Proficiency in Clinical and Administrative Applications preferred at time of hire; incumbents within position will be trained appropriately and then skill will be required for this position within 30-60 days from date of hire.
PERFORMANCE EXPECTATIONS
Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.
WORK ENVIRONMENT
Potential for exposure to the hazards and risk of the hospital environment, including exposure to infectious disease, hazardous substances, and potential injury. This position requires sitting, standing, walking, stooping and crouching a majority of the workday. Requires lifting up to 20
pounds occasionally. Works with such equipment as computer terminal, fax machine, printer and copier.
REPORTING RELATIONSHIP
This position reports to department leadership.The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.
Total Rewards at AtlantiCare
At AtlantiCare, we believe in supporting the whole person. Our market-competitive Total Rewards package is designed to promote the physical, emotional, social, and financial well-being of our team members. We offer a comprehensive suite of benefits and resources, including:
Generous Paid Time Off (PTO)
Medical, Prescription Drug, Dental & Vision Insurance
Retirement Plans with employer contributions
Short-Term & Long-Term Disability Coverage
Life & Accidental Death & Dismemberment Insurance
Tuition Reimbursement to support your educational goals
Flexible Spending Accounts (FSAs) for healthcare and dependent care
Wellness Programs to help you thrive
Voluntary Benefits, including Pet Insurance and more
Benefits offerings may vary based on position and are subject to eligibility requirements.
Join a team that values your well-being and invests in your future.