PeaceHealth is seeking a Coding Auditor Educator - Hospital Coding for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $34.74 - $52.12. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.
Job Summary
The coding reviewer acts as an expert resource for auditing and training in support of accuracy and appropriateness of coding using ICD-10 and CPT industry standards and PeaceHealth guidelines.
Essential Functions
- Performs coding audits and pre-billing coding compliance functions as required by system regulatory policies/procedures and established review metrics. Participates in development of action plans to include follow up education on identified issues with subsequent audit and reassessment. Utilizes a vendor-based pre-billing compliance tool to review targeted records for coding accuracy, mortality, PSI and HAC review. Also performs post-billing medical record review focused on DRG validation.
- Develops training materials and curriculum for coding, external vendor, and CDI caregiver's education.
- Serves as an expert resource for ICD-10/CPT as it affects coding, compliance and reimbursement. Assists with re-training efforts as a result of coding errors found. Delivers training and standards as directed.
- Reviews records for payor, RAC, regulatory denials/appeals, and downgrades by providing in depth coding review, audit findings and appeal strategies to the System Coding Leadership.
- Works in tandem with HIM Coding team to identify aberrant coding patterns and trends.
- May participate in integrated testing of Epic, 3M, or other external vendor software.
- May provide production coding support as required.
- Performs other duties as assigned.
Qualifications
Education
- Accredited Program Required: Coding or a combination of education and experience that provides the caregiver with the requisite knowledge, skills and abilities to perform the job and
- Preferred: Completion of a college-based or AHIMA approved coding education program
Experience
- Minimum of 3 years Required: Acute care coding and/or auditing experience and
- Preferred: Previous training experience
Credentials
- Required: Registered Health Information Administrator or
- Required: Registered Health Information Technician or
- Required: Certified Coding Specialist or
- Required: Certified Coding Associate or
- Required: Certified Inpatient Coder or
- Required: Certified Professional Coder - Apprentice or
- Required: Certified Professional Coder
Skills
- Knowledge including ICD-10, MS-DRG/APR-DRG methodology, HCPCS/CPT coding, regulatory policies from CMS and other third-party regulations. (Required)
- Hands-on ICD-10 and/or CPT proficiency (Required)
- Excellent verbal and written communication skills including sensitivity to other cultures and ethnicities. (Required)
- Strong analytical skills. (Required)
- Must possess excellent ability for conceptual thinking, good listening, problem resolution and planning skills. (Required)
- Must possess excellent organizational skills. (Required)
- Must demonstrate computer skills in Microsoft Office (Required)
- Ability to work well independently and in a remote environment. (Required)
Working Conditions
Lifting
- Consistently operates computer and other office equipment.
- Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
- Sedentary work.
Environmental Conditions
- Predominantly operates in an office environment.
Mental/Visual
- Ability to communicate and exchange accurate information.
- The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.
See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.