Revenue Cycle Auditor-Educator CDI
Job Summary
You will bring expert knowledge of current ICD (diagnostic and procedural) and CPT-4 coding classification systems to this advanced-level role. You will be front-and-center in ensuring the utmost accuracy and compliance in all healthcare coding and billing practices, directly impacting our organization's financial health and regulatory standing.
Responsibilities
Take the lead in answering complex coding and billing questions.
Facilitate the onboarding and training of new staff.
Perform critical coding/DRG validation audits.
Design, develop, and deploy comprehensive coding and CDI education programs across our system.
Conduct internal audits.
Provide follow-up education.
Promote standardization of coding/CDI practices.
Communicate vital regulatory changes for timely implementation.
Complete initial medical records reviews within 24-48 hours of admission for a specified patient population to evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality and severity of illness.
Conduct follow-up reviews every 2-3 days to support working DRG assignment.
Formulate compliant provider queries regarding missing, unclear or conflicting documentation, as necessary.
Follow up daily on open queries with providers to ensure timely responses.
Review final coding DRG assignment follows DRG reconciliation process.
Keep abreast of Official Coding and Reporting Guidelines, AHA Coding Clinics, CMS and other agency directives and maintain up to date knowledge of coding and CDI current trends.
Strong oral communication skills and the ability to deliver presentations to large groups.
Requirements
Required:
Associates degree in Nursing and or HIM related fields or 4-6 years coding auditing experience including but not limited to hospital inpatient and outpatient encounters.
Six (6) years of experience in coding quality audit work or record review including but not limited to hospital inpatient and outpatient.
Certified Coding Specialist
Certified Professional Coder
Registered Health Information Administrator
Registered Health Information Technician
Clinical Documentation Improvement Professional
Preferred:
In relevant field or combination of equivalent of education and experience.