Manager – Coding Quality, Audit & Education

🕒 4 dias atrás

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $70 - $93 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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Stanford Health Care

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1885

🏥 Saúde

Healthcare

Stanford Health Care é um grande centro médico acadêmico e sistema hospitalar integrado que oferece cuidados clínicos abrangentes, serviços especializados e suporte ao paciente. A organização opera hospitais, clínicas ambulatoriais e programas, oferece ensaios clínicos e telemedicina (consultas por vídeo), e fornece serviços voltados para o paciente, como um portal do paciente MyHealth, assistência com faturamento/seguro e recursos para médicos de referência, enfermeiros e profissionais de saúde aliados. Também se engaja com a comunidade por meio de doações, serviços para visitantes e recursos relacionados à COVID-19.

Descrição

• Provide enterprise leadership for coding accuracy, audit oversight, regulatory compliance, and coder/physician education across inpatient, outpatient, and professional services • Communicate coding regulation, policy, and guideline changes health system wide • Serve as a coding resource and subject matter expert for Revenue Integrity, physicians, administration, and Stanford Healthcare • Develop and provide coding compliance education and training programs • Train newly hired and contractor coding auditor and educators • Monitor the Coding Audit & Education team and report standardized monthly results • Maintain and update the Coding Audit Policy • Ensure monthly or quarterly audits of internal and contractor coders • Conduct and oversee retrospective, prospective, targeted, external, and internal coding audits • Apply standardized scoring methodologies and report monitoring results • Prepare audit reports, executive summaries, recommendations, and management presentations • Communicate audit findings to coding management, physicians, providers, vendors, contractors, and departments • Evaluate coding audits and education for regulatory and compliance effectiveness • Research and communicate federal, state, payer, Medicare, Medi-Cal, ICD, CPT, and Coding Clinic rules and updates • Assess medical record documentation and identify trends and issues for resolution • Assure accuracy and compliance of coding, MS and APR DRG, APC, ICD-10-CM, CPT, and HCPCS assignments • Lead audits across inpatient, outpatient, and professional coding environments • Establish risk-based audit priorities • Create or update Revenue Cycle Academy e-learning webinars and physician onboarding education • Participate in faculty meetings, multidisciplinary committees, and code-dependent initiatives • Administer the compliance work plan/program for correct coding and auditing • Govern and manage professional unlisted, custom, and special procedure codes • Partner with clinical, coding, compliance, revenue cycle, pricing, and finance departments on new technologies, procedures, and atypical services

🎯 Requisitos

• Bachelors Degree in a work-related field / discipline from an accredited college or university; relevant experience in lieu of degree may be considered with approval and is in addition to the experience requirements • Masters Degree in a work-related field/discipline preferred • 5–7 years of progressively responsible, directly related experience, including at least 2 years in coding, auditing, and education • EPIC experience is required • 3 or more years in an academic medical center preferred • Experience with auditing software preferred • Elevated knowledge and skillset in professional coding and/or outpatient and inpatient hospital coding settings • Elevated knowledge and skillset in auditing and education within coding settings • Ability to analyze problems and understand regulatory and reimbursement impacts • Critical thinking skills and ability to assess, evaluate, and teach clinical concepts • Effective written and verbal communication, including summarizing data and presenting results • Advanced understanding of regulatory guidelines and official coding advice • Ability to comply with AHIMA Code of Ethics, Standards of Ethical Coding, and UHDDS standards • Knowledge and understanding of HIPAA • Advanced knowledge of ICD-10-CM/PCS and CPT-4 coding conventions • Knowledge of medical records, coding systems, medical terminology, anatomy and physiology, and diseases • Knowledge of privacy regulations and confidentiality • CCS (Certified Coding Specialist) required • RHIT, RHIA, CPC and/or CCSP preferred