Job Description

Location: Steward Health Care
Posted Date: 9/19/2022

POSITION SUMMARY:

(Briefly describe the overall purpose of this position - Why does it exist and how does it contribute to the overall organization?)

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:

(Use bullets for specific 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:

(Examples: Ability to work independently and take initiative; Good judgment and problem solving skills; Communication skills; Interpersonal and organizational skills; Level of confidentiality)

  • 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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