Compliance auditor [h1.location_city]

Job Description

Responsibilities

POSITION SUMMARY :

Responsible for improving the overall quality, completeness and appropriate utilization of systems used to perform coding functions for the South Texas Region. Compliance Auditor focuses on coding compliance with the rules and regulations of regulatory agencies, compliance with South Texas Region / UHS policies and procedures. Promotes a partnership between the concurrent clinical reviewers, medical record coders, and physicians to improve documentation and reimbursement for each facility. Supports and promotes the accuracy and completeness of the clinical information used for measuring and reporting physician and hospital outcomes to reflect the patient’s true severity of illness, intensity of care, and risk of mortality. Responsible for internal audits, appeals, research on coding guidelines and / or regulations. Communicates with Coding Manager, Supervisors and HIM management to accomplish hospital’s objectives. Educates members of the health care team on an ongoing basis regarding coding compliance and new or updated coding clinics and assists with coding needs when needed. Position is a remote position with occasional need to work from the facility and / or attend meetings.

Qualifications

QUALIFICATIONS :

1. 5 to 8 years acute care inpatient and outpatient coding experience required

2. Excellent written and verbal communication skills required.

3. One to two years experience in leadership role, preferred.

4. Auditing experience of acute care IP / OP coding required.

5. Demonstrates ability to review all coding skills related to assignment of diagnosis, procedures and DRG’s

6. Ability to read medical reports, interpret lab values pertinent to coding diagnoses, abstract pertinent

information from records and to provide meaningful information by telephone or letter in replying to

inquiries.

7. Medical terminology, anatomy and physiology required.

8. Computer skills and excellent customer service skills are required.

9. Ability to recognize, analyze and resolve process problems.

• . Flexibility of scheduled and ability to work remotely. Must be able to provide high speed internet at place of residence at the expense of the employee, with a work area that is in adherence to privacy and security policies and procedures.
• . Must demonstrate commitment and adherence to STHS’s Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer.

EDUCATION / LICENSURE :

1. Certified Coding Specialist certification from AHIMA required

2. Associates Degree with RHIT certification from AHIMA preferred

3. Bachelors Degree with RHIA certification from AHIMA a plus

4. Able to travel amongst the facilities.