Job Description
Coding Integrity Coordinator/Educator Position Summary The Coding Integrity Coordinator is responsible for monitoring and performing audits on inpatient or outpatient coded data for accuracy based on documentation in the medical record and through these audits will ensure medical records are coded and billed in accordance with coding conventions, billing rules, Federal & State regulations and RGHS policies. The Coding Integrity Coordinator recommends / provides / coordinates training, education and feedback to all coders regarding coding regulations and compliance; serves in an advisory and educator capacity to coding staff, medical staff and other RGHS team members as it relates to documentation, coding and regulatory compliance; provides mentoring for new coding staff and assists Coding leadership with improving coding services.
Key Responsibilities: •Conducts on-going audits of inpatient and/or outpatient coded data.
•Provides on-going coder training and education.
•Serves as subject matter expert on documentation, coding and regulatory compliance.
•Compiles information and/or prepares reports and analysis of data integrity findings with recommendations.
•Performs subsequent audits to ensure complete and appropriate corrective follow-up.
•Works collaboratively with HIM leaders (Coding Managers, CDI Manager and Coding Director) to develop education strategies to promote complete and accurate clinical documentation.
•Reports negative trends with clinical documentation to HIM Coding leaders.
•Performs the RAC and DRG Validation Reviews and Queries.
•Educates on findings/trends.
•May processes outpatient and inpatient denials and rejections.
•Assists in the on-going development and maintenance of coding policies and practice standards.
•Supports the education and compliance for post query, re-coding and re-billing process.
•Acts as the HIM liaison with external coding auditors.
•Perform other related responsibilities related to the work described here.
•Perform other duties as assigned.
Minimum Qualifications: •Associates or Bachelor's degree in HIM.
•Five years of recent inpatient and/or outpatient coding experience in an acute care setting.
•Extensive knowledge of coding principles and guidelines.
•Extensive knowledge of reimbursement systems, as well as federal, state and payer-specific regulations and policies pertaining to documentation, coding and billing.
•Knowledge of RAC process including targeted DRGs.
•Experience as an educator/trainer strongly preferred.
•Knowledge of EPIC preferred.
•Analytical ability to gather and interpret data, to evaluate reports and track process and to determine methods for ensuring coding compliance.
•Strong communication, organizational and time management skills.
•Results oriented with demonstrated skills in problem identification and resolution.
•Must be self-motivated and require minimal supervision with the ability to establish own priorities.
•Must have the ability to interact professionally with providers, management, and staff.
•Proficient in Microsoft Office applications and others as required.
•Applicant must successfully pass a practical coding examination.
Required Licensure/Certification Skills: Successful completion of AHIMA or AAPC approved Coding Certificate required.
Advance coding certification credential: CCS, CCS-P, CPC, CPC-H, CMC, preferred.
If RHIT or RHIA is held, certifications are not required.
EDUCATION: AS: Health Information Management (Required)
LICENSES / CERTIFICATIONS: PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements. Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations. PAY RANGE: $57,000.00 - $75,500.00
CITY: Rochester
POSTAL CODE: 14617
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts. Rochester Regional Health is an Equal Opportunity/Affirmative Action Employer.
Minority/Female/Disability/Veterans by a prospective employee and/or employee's Physician or delegate will be considered for accommodations.
Job Tags
Full time,