Auditor/Educator, Coding DRG Facility

We are recruiting for a Auditor/Educator, Coding DRG Facility to join our team!

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Department

HB & PB Coding Services

Job Summary

Under general supervision, trains and educates providers, hospital and coding staff on all aspects of inpatient facility coding and documentation as it applies to the inpatient hospital/facility setting. Prepares training and presentations on applicable topics. Researches questions and issues using all available resources. Provides both oral and written direction to coders when a provider query should be sent. Creates and approves content of queries for submission to providers. Interacts with hospital staff for the purpose of documentation improvement and clarification. Performs audits to ensure documentation and coding accuracy compliance. Reviews appropriate assignment of Major Comorbid Conditions (MCCs) and Comorbid Conditions (CCs). Provides feedback from audit findings for documentation and coding quality improvement. Participates in outside audit reviews with other departments including Clinical Documentation Improvement and Enterprise Compliance Services for all RAC, individual payer, and other outside agencies. Utilizes all available coding references to include software applications to perform coding related tasks.

Essential Functions :

• Performs audits of documentation and coding to ensure coding accuracy compliance. Provides feedback to coders from audits for quality improvement. Educates and trains on all aspects of inpatient coding. Prepares training and presentations on various topics, including Quarterly Coding Clinic Reviews.Training can be one-on-one or in a group. (50%)
• Coordinates and updates the annual review of Denver Health's Code/Do Not Code Guidelines, in collaboration with the HB IP Coding ManagerReviews and responds to clinical coding validation requests from Clinical Documentation Improvement (CDI) and Enterprise Compliance Services (ECS).Evaluates CDI mismatch encounters and provides feedback to CDI, coding, and management as needed. Participates, reviews and, if necessary, responds to any external audit finding(s) for the department. (10%)
• Creates, reviews, and revises standardized coding queries for inpatient coding use. Provides standardized training for provider queries and educates coders on appropriate situations to query. (10%)
• Reviews queries and provides feedback to areas where improvement is needed.Elevates potential areas requiring additional provider education to Director of Coding; Manager, Facility Coding; Audit and Education Manager, and CDI. (10%)
• Maintains advanced knowledge of Diagnostic Related Group (DRG), Risk of Mortality (ROM), Severity of Illness (SOI), and Present on Admission (POA) methodologies. Maintains any current coding credential(s). (5%)
• Continues to be educated and updated in using coding software and related systems.Researches questions, changes in regulatory compliance, guidelines, and other topics using all available resources. (10%)
• Participates in departmental coding and educational meetings and trainings. Reads and communicates information in applicable publications IPPS Updates (5%)

Education :

• High School Diploma or GED Required
• Bachelor's Degree Preferred

Work Experience :

• 4-6 years years Facility medical coding experience assigning ICD-10-CM diagnoses codes, ICD-10-PCS procedure codes, HCPCS, and modifiers codes for multi-specialty areas required. Required
• years' experience with Diagnostic Related Group (DRG) and Ambulatory Payment Classification (APC) fundamentals required. Required
• 3.Experience reviewing medical record documentation required. Required
• 4.Experience with education, training, compliance, and auditing required. Required

Licenses :

• CCS - Certified Coding Specialist - AHIMA - American Health Information Management Association Required or
• AHIMA-AHIMA Member - AHIMA - American Health Information Management Association

Knowledge, Skills and Abilities :

• 1. Possess and applies a thorough knowledge of coding, documentation, applicable guidelines, and compliance as it relates to our hospital-based, academic setting
• 2. Thorough knowledge of billing, reimbursement, and anatomy and physiology.
• 3. Ability to professionally interact with physicians and clinic staff.
• 4. Ability to work with all personnel throughout Denver Health.
• 5. Must be capable of reading and interpreting coding guidelines and making subsequent coding decisions.
• 6. Knowledgeable in researching coding related topics and issues.
• 7. Must pass a coding proficiency pre-hire test with 85% accuracy or higher.
• 8. Ability to work independently, possess critical thinking skills, audit, and provide appropriate feedback.
• 9. Ability to create training material and presentations
• 10. Possess strong organizational skills and the ability to work independently and meet deadlines
• 11. Possess strong oral and written communication skills
• 12. Demonstrates advanced leadership and teambuilding skills.

Shift

Varies (United States of America)

Work Type

Regular

Salary

$78, - $118, / yr

Benefits

• Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to , and generous medical plans

• Free RTD EcoPass (public transportation)

• On-site employee fitness center and wellness classes

• Childcare discount programs & exclusive perks on large brands, travel, and more

• Tuition reimbursement & assistance

• Education & development opportunities including career pathways and coaching

• Professional clinical advancement program & shared governance

• Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF programÂ

• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

Our Values

• Respect

• Belonging

• Accountability

• Transparency

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