Job Description

Location: Steward Health Care
Posted Date: 8/25/2021

POSITION SUMMARY:

Conducts outpatient coding quality audits to validate code assignment is supported by clinical documentation in the medical record. Highly proficient in the proper assignment of ICD-10 CM, ICD PCS, CPT, HCPCS, and modifier codes.

KEY RESPONSIBILITIES:

  • Performs coding audits of a wide variety of complex outpatient services including outpatient surgical, observation, emergency department, diagnostic outpatient, clinic, and series accounts. Also prefer experience in interventional radiology, E&M leveling and coding of injections and infusions.
  • Provides written, detailed rationale and supporting evidence for recommendations on audit findings.
  • Delivers educational feedback to coding staff regarding audit findings.
  • Provides guidance to coding staff and management in identifying and resolving coding issues.
  • Identifies documentation improvement opportunities that impact coding accuracy.
  • Reviews and research billing edits.
  • Ability to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding compliance.
  • Maintains a minimum of 95% accuracy on all coding audits.
  • Maintains productivity standard for outpatient coding reviews, dependent upon type of review.
    • Emergency Department – 8 per hour
    • Same Day Surgery – 4 per hour
    • Observation – 4 per hour
    • Cardiac Cath/IVR – 3 per hour
    • Ancillary – 20 per hour
    • Oncology Infusions – 6 per hour
    • Wound Care – 5 per hour
  • Performs other duties as assigned including training/mentoring of new staff and performing research related to special projects

REQUIRED KNOWLEDGE & SKILLS:

  • Comprehensive understanding of coding guidelines, CCI edits, Coding Clinics and CPT assistant, along with ability to employ coding resources to audit findings.
  • Excellent interpersonal verbal and written communication skills to accurately relay information to internal and external customers.
  • Excellent organizational skills with ability to trend and track audit findings effectively.
  • Excellent problem-solving skills, the ability to work independently, and to perform under pressure in a teamwork manner with diplomacy and tact.
  • Proficient computer and technical skills, along with experience using MS Word, Excel and PowerPoint.
  • Ability to meet assigned deadlines.

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

  1. Education: Associates degree in Health Information (RHIT), or associates degree in applicable healthcare field.
  2. Experience 3-5 years progressive coding experience in acute care hospital setting, including auditing
  3. Certification/Licensure: AHIMA or AAPC certification required, such as RHIA, RHIT, CCS, CIRCC, CPC, COC
  4. Software/Hardware: Meditech and 3M 360 experience required
  5. Other: This is a remote position and must live within a Steward hiring state.
  6. Travel: Expected travel is up to 10%. Education and/or company growth.

Application Instructions

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