Coding Auditor Educator - Hospital Coding

About the role

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.

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.

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
• 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
• 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

• 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.
• 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.