Steward Health Care System
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HIM Outpatient Coding Auditor
at Steward Health Care System
Conducts outpatient coding quality audits to validate code assignment is supported by clinical documentation in the medical record. Highly proficient in the proper assignment of ICD-10 CM, ICD PCS, CPT, HCPCS, and modifier codes.
- Performs coding audits of a wide variety of complex outpatient services including outpatient surgical, observation, emergency department, diagnostic outpatient, clinic, and series accounts. Also prefer experience in interventional radiology, E&M leveling and coding of injections and infusions.
- Provides written, detailed rationale and supporting evidence for recommendations on audit findings.
- Delivers educational feedback to coding staff regarding audit findings.
- Provides guidance to coding staff and management in identifying and resolving coding issues.
- Identifies documentation improvement opportunities that impact coding accuracy.
- Reviews and researches billing edits.
- Ability to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding compliance.
- Performs other duties as assigned including training/mentoring of new staff and performing research related to special projects
Key Knowledge and Skills
- Comprehensive understanding of coding guidelines, CCI edits, Coding Clinics and CPT assistant, along with ability to employ coding resources to audit findings.
- Excellent interpersonal verbal and written communication skills to accurately relay information to internal and external customers.
- Excellent organizational skills with ability to trend and track audit findings effectively.
- Excellent problem-solving skills, the ability to work independently, and to perform under pressure in a teamwork manner with diplomacy and tact.
- Proficient computer and technical skills, along with experience using MS Word, Excel and PowerPoint.
- Ability to meet assigned deadlines.
Required Education and Licensure
- Education: Associates degree in Health Information (RHIT), or associate degree in applicable healthcare field.
- Experience 3-5 years progressive coding experience in acute care hospital setting, including auditing
- Certification/Licensure: AHIMA or AAPC certification required, such as RHIA, RHIT, CCS, CIRCC, CPC, COC
- Software/Hardware: Meditech and 3M 360 experience required
- Other: Required to work out of Steward Health Care office located in Richardson, Texas.
- Travel: Expected travel is up to 10%. Education and/or company growth.