Coding Auditor at AdventHealth in MAITLAND, Florida

Job Description:

Description

YOU ARE REQUIRED TO SUBMIT A RESUME WITH YOUR APPLICATION! 

                  

Coding Auditor at AdventHealth at Maitland

 

Location Address: 900 WINDERLEY PL, Maitland, 32751

 

Top Reasons to work at AdventHealth Maitland :

• Located on a lush tropical campus, our flagship hospital, 1,368-bed AdventHealth Orlando
• serves as the major tertiary facility for much of the Southeast, the Caribbean and South America
• AdventHealth Orlando houses one of the largest Emergency Departments and largest cardiac catheterization labs in the country
• We are already one of the busiest hospitals in the nation, providing service excellence to more than 32,000 inpatients and 125,000 outpatients each year

 

Work Hours/Shift:  Monday - Friday 8am-4:30pm, Full Time (Remote Position)

 

You Will Be Responsible For:

· Performs quality reviews on coded records to validate ICD-9, ICD-10, ICD-10-PCS, MSDRG, APRDRGs, CPT, APC and overall coding accuracy retrospectively and concurrently at all Florida Hospital campuses including other Adventist Health Systems facilities as needed

· Provides continuing education to individual coders and to the coding staff concerning changes in the coding and reimbursement system as well as any area of weakness identified during the performance of coding validation reviews

· Prepares statistical reports conveying the individual and overall accuracy of coding

· Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist.  Effectively communicates with physicians and allied health personnel the need for comprehensive, accurate timely clinical documentation

· Assists with writing compelling appeals to all DRG or APC denials from outside agencies referencing Official Coding Guidelines and Coding Clinic advice as appropriate to defend the DRG/APC assignment as well as protect the organizations reimbursement

 

· Serves as a resource to other departments in the Revenue Cycle to ensure business continuity and optimal revenue cycle management

· Uses critical thinking and sound judgment in decision making; keeping reimbursement considerations in balance with regulatory compliance

· Assumes personal responsibility for professional growth, development and continuing education to maintain a high level of proficiency

· Maintains the confidentiality of employees, patients, administrative and medical staff information with no infractions

· Performs other duties as assigned

Qualifications

What You Will Need:

KNOWLEDGE AND SKILLS REQUIRED:

· Expansive knowledge of Medicare DRGs, APCs, coding guidelines and reimbursement systems including MS Office and Encoder software experience. 

· Ability to communicate effectively with physicians and other allied health personnel

· Computer skills to include Microsoft Office

· Self motivated and ability to work independently in a remote setting

· Critical thinking and problem-solving skills

· Thorough knowledge of medical terminology, anatomy & physiology, and pathophysiology

· Ability to educate effectively

 

PREFERRED KNOWLEDGE AND SKILLS:

· Microsoft Excel Proficiency

-Epic Software Experience

 

EDUCATION AND EXPERIENCE REQUIRED:

· At least 5 years proven hospital coding experience

 

PREFERRED EDUCATION AND EXPERIENCE:

· Previous Coding auditing experience          

· Successful completion of at least a two year coding education program

 

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:

            RHIA, RHIT, or CCS certification or credential.

 

GENERAL SUMMARY:

The Data Quality Reviewer, under general supervision of the Coding Quality Manager, is responsible for validating the coding that is performed by inpatient or outpatient coders. Random samples and/or target samples are reviewed, and the results provided to management as well as 
feedback to the individual coder.  Assist with education of all coders and Medical Staff members, while demonstrating willingness to educate throughout the organization as needed.  Maintains extensive knowledge of all coding standards and is able to effectively communicate to all 
appropriate individuals. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

 

 

 

 

 

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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