Professional Coding Auditor-Educator

About the role

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff.

Responsibilities

• Manages activities of designated coding personnel in training for WVU Healthcare and assures the monitoring and reporting of respective employee’s developmental activity.
• Manages quality improvement audits and training of designated coding staff.
• Acts as expert coding resource not only to coders, clinical documentation improvement, providers and revenue cycle, but also to specialty groups and meetings.
• Acts as Super user for all Coding-related Electronic Medical Record Systems necessary for complete an accurate coding and EMR Data Governance.
• Updates policies and procedures for those areas of responsibility.
• In-services appropriate staff regarding changes in these areas.
• Develops and maintains coding related policies, procedures, query development, work queues and training materials in conjunction with management.
• Continually communicates with Coding Staff, Medical Staff, Physician Advisor, Department Chairman, and Department Administrators.
• Organizes, facilitates, performs, tracks, trends, and reports on internal quality reviews.
• Designs and uses audit tools (i.e ROC) to monitor the accuracy of coding, documentation gaps, and billing performed by Coding Specialists.
• Captures and analyzes from various sources then develops action plan when necessary.
• Absorbs and updates Coding Specialists on compliance and other regulatory changes.
• Ensures audit (external and internal) recommendations are completed (i.e. coding education, coding changes, rebills).
• Aids in on-boarding of new Coding Specialists in regard to coding/quality related policies, audits and initiatives.
• Utilizes all necessary systems as part of curriculum and educational courses and administers exams.
• Involves in testing and installation of system upgrades when necessary to assure curriculum is up-to-date.

Requirements

Minimum Qualifications:

• Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR
• Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR
• High School Diploma or Equivalent AND Eight (8) years of coding experience.

• Certification in ONE of the following: Registered Health Information Administrator (RHIA) OR Registered Health Information Technician (RHIT) through American Health Information Management Association) Certified Outpatient Coder (COC) through American Academy of Professional Coders Certified Coding Specialist (CCS) through American Health Information Management Association Certified Professional Coder (CPC) through American Academy of Professional Coders.

Preferred Qualifications

• Bachelor’s degree in Health Information Management or related field.
• Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” for Professional Coding Positions preferred.
• Previous supervisory or project management experience.