Professional Coding Auditor – Educator

🕒 5 days ago

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WVU Medicine

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

Healthcare Insurance

WVU Medicine is a comprehensive health system affiliated with West Virginia University, providing medical services through a network of hospitals across West Virginia. The system includes notable facilities such as J. W. Ruby Memorial Hospital, WVU Medicine Children's, and various other regional medical centers. WVU Medicine offers a wide range of healthcare services, including specialized and advanced medical treatments such as robotic heart surgery. It's also involved in medical education, research, and community health initiatives, emphasizing a mission of delivering high-quality care to the communities it serves.

📋 Description

• Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. • Oversee or perform the overall auditing and education plans for the Coding staff. • Perform coding quality audits, provide ongoing feedback and education. • Utilize various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. • Manages activities of designated coding personnel in training for WVU Healthcare. • Manages quality improvement audits and training of designated coding staff. • Acts as expert coding resource not only to coders, clinical documentation improvement, providers and revenue cycle, but also to specialty groups and meetings. • Updates policies and procedures for those areas of responsibility. In-services appropriate staff regarding changes in these areas. • Develops and maintains coding related policies, procedures, query development, work queues and training materials in conjunction with management. • Continually communicates with Coding Staff, Medical Staff, Physician Advisor, Department Chairman, and Department Administrators. • Designs and uses audit tools (i.e ROC) to monitor the accuracy of coding, documentation gaps, and billing performed by Coding Specialists. • Coordinates audits performed by outside agencies by obtaining accounts to be reviewed, acting as a liaison between agency and HIM personnel to gather data to be reviewed, facilitating exit conferences with Coding Specialists, and providing final reports to Coding Manager.

🎯 Requirements

• Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience. • Certification in ONE of the following: Registered Health Information Administrator (RHIA) OR Registered Health Information Technician (RHIT) through American Health Information Management Association ) Certified Outpatient Coder (COC) through American Academy of Professional Coders Certified Coding Specialist (CCS) through American Health Information Management Association Certified Professional Coder (CPC) through American Academy of Professional Coders. • Bachelor’s degree in Health Information Management or related field preferred. • Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” for Professional Coding Positions preferred. • Previous supervisory or project management experience.

🏖️ Benefits

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.