Coding Auditor Jobs in Texas (NOW HIRING)

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Job Posting Title:

Location:

Additional Posting Details:

Primary Location Address

Hybrid

Monday - Friday

8am - 5pm

Job Description:

Job Description

• Establishes and maintains an efficient and timely coding, auditing, and education process while ensuring the accuracy and quality of coded and abstracted information for all patient types across physician services and campuses of Scottish Rite Childrens Hospital. Provides ongoing education to coders, physicians, and other clinical staff. Serves in a management and advisory capacity to the Coding staff and in an educational and advisory capacity to the clinical staff and physicians as it relates to documentation, coding, and regulatory compliance. Works effectively with leadership and coding team to increase and improve coding services.

Duties/Responsibilities

• Manages the daily operations of the Hospital Coding Department to promote steady workflow and data integrity.
• Manages the daily operations of the Physician Practice Coding Department to promote steady workflow and data integrity.
• Collaborate with and educate physicians on coding and documentation guidelines.
• Research coding questions and provide coder feedback - Ensures timely correction of coding errors and edits.
• Ensures coding audits are performed concurrently and that the areas being audited are updated in conjunction with the department policies.
• Oversees the monitoring of the aging and DNB accounts to ensure that accounts are coded in a timely manner and that performance is within established coding quality and productivity benchmarks.
• Conducts regular audits and coordinates monitoring of coding accuracy, productivity, and available clinical documentation.
• Ensures that audit reports are reviewed, accurate, and corrective action plans implemented.
• Provides feedback and assists in facilitating and/or coordinating focused educational programs regarding coding and clinical documentation best practices to Coding and clinical staff as needed.
• Interviews, hires and trains employees; plans, assigns and direct workflow, appraises employee performance; addresses complaints and resolving problems; and proactively manages production and quality control efforts.
• Conducts trend analysis to identify patterns and variations in coding/documentation practices and case mix index.
• Identifies process improvement opportunities within the Coding department and implements solutions.
• Reviews claim denials and rejections pertaining to coding and medical necessity issues and implements corrective action plans as needed/required.
• Works to provide all Coding staff with annual, quarterly, semi-annual ICD-10-CM/PCS and/or CPT code changes.
• Maintains all coding information and provides updated manuals, resources, and other coding material.
• Maintain strong communication with Director(s) and business partners in reporting of unbilled activities related to coding.
• Mentors team members to encourage personal and professional growth.
• Encourages ongoing skill development by providing opportunities for continued education.
• Applies critical thinking, problem solving and change management skills to lead the process and team in identifying and resolving systemic issues.
• Develop, implement and monitor policies and procedures, guidelines, and coding compliance plan for coding.

Required Skills/Abilities

• Proven knowledge base in complete and accurate clinical documentation in all healthcare settings and for all healthcare disciplines.
• Demonstrated knowledge base and experience in acute care hospital and physician/clinic coding and billing practices.
• Demonstrated knowledge of the conventions, rules, and guidelines for multiple classification systems, including ICD-10 diagnosis and procedures, CPT and Evaluation & Management coding systems.
• Knowledge of multiple reimbursement systems (e.g., Medicare Severity-Diagnosis Related Groups (MS-DRG) and Ambulatory Payment Classification (APC)
• Knowledge of clinical documentation improvement methodologies.
• Ability to establish rapport with physicians and other healthcare practitioners.
• Must have strong analytical and critical thinking skills to support problem solving and associated change management.
• Prior use of 3M encoder and Epic software is preferred.

Education

• Associates degree in Health Information Management/Health Information Technology, or related healthcare field, or 3 years of managerial experience in Health Information Management or Coding

Certification

• Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), or Certified Professional Coder (CPC).

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