Remote Credentialing Auditor Jobs in Virginia (NOW HIRING)

The Auditor/Educator Inpatient Coding performs internal Inpatient coding audits and coordinates Inpatient coder education in the Health Information Management department. Conducts data quality audits of inpatient encounters to validate coding assignments is in compliance with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Prepares and distributes audit results/reports to Coding Management staff. Prepares and presents education to Inpatient coding staff based on audit findings and denials related to Inpatient coding following ICD-10 Coding Conventions, Official Guidelines for Coding & Reporting, and American Hospital Association Coding Clinic guidance. Assists in the development of programs and procedures to support improvement of coding accuracy rate.

Required Qualifications:

• Associate degree in health information management or a related field 
• Minimum of five (5) years of hospital Inpatient coding experience
• In-depth knowledge of ICD-10-CM and ICD-10-PCS
• Proficient in Diagnosis Related Groups structure (MS-DRG, APR-DRG), and Inpatient Prospective Payment System
• Knowledge of reimbursement methodologies and claims processing. 
• Ability to develop educational materials and job aids pertaining to Inpatient coding. 
• American Health Information Management Association credentialed, RHIT or CCS
• Proficient in Microsoft Office Products including Word, Excel, and PowerPoint
• Strong Analytical skills, Critical Thinking, and excellent verbal and written communication skills

Preferred Qualifications: 

• Bachelor's degree in health information management or related field 
• Previous Inpatient auditing experience

Salary Range: $30.78-$44.65/hr

Essential Duties and Responsibilities:

• This position will work with the Corporate Director of Health Information Management and Inpatient Coding Manager to design, plan, and organize training programs and timelines for new hire and ongoing staff education.
• Monitors and reports coders progress through the orientation and training process.
• Develops ongoing audit schedule for all Inpatient  coding staff and reviews cases for accurate ICD-10-CM/PCS, Diagnosis Related Group,  Present on Admission Indicators, Severity of Illness,  Risk of Mortality, and  discharge disposition assignments.
• Conducts random and focused quality audits on all Inpatient Centra and contracted/vendor coding staff.
• Documents audit findings, trends and ensures they are investigated, and timely education is prepared and reviewed with coding staff when necessary.
• Keeps abreast of new regulatory requirements, annual revisions to the codes, etc. and applies this information appropriately.
• Communicates clearly, leads innovative and engaging training and education sessions for Inpatient coding staff development.
• Serves as a resource and subject matter expert to Inpatient coding staff
• Monitors changes in laws, regulations, standards as they affect coding, billing, and related compliance. 
• Develops and maintains Inpatient  facility specific coding guidelines.
• Attend Inpatient  Denials Management meetings.
• Assists with the analysis of Case Mix Index (CMI) reports.
• Shares audit trends and key findings with Health Information Management team. Participates in strategic planning workgroups to develop and plan education curriculums.

Other Functions:

• Maintains strict confidentiality of all information, including financial/operational, employee/human resource, healthcare/patient data and information.
• Works in close collaboration with Inpatient Coding Manager and Corporate Director of Health Information to ensure timely, accurate education. 
• Performs other duties as assigned.