Coding Audit Coordinator

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⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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👻 Ghost score 11%

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Franciscan Missionaries of Our Lady Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1911

🏥 Healthcare

🤝 Non-profit

🌍 Social Impact

Healthcare • Non-profit • Social Impact

Franciscan Missionaries of Our Lady Health System is one of the largest healthcare systems in Louisiana, serving over half of the state's population and the largest metropolitan area in Mississippi. This non-profit, Catholic organization offers a comprehensive range of healthcare services through its network of hospitals, clinics, and physicians, focusing on quality patient care, community health, and education. Headquartered in Baton Rouge, Louisiana, the mission of the organization is to provide excellence in health services and to care for the sick across Louisiana and Mississippi.

📋 Description

• Review documentation and coding of hospital records to ensure compliance with federal and state laws and regulations • Assist in developing, performing, and maintaining a comprehensive clinical coding audit program for inpatient and outpatient coding • Conduct coding compliance, charge-based, inpatient, and outpatient coding audits and reviews • Perform quarterly complex coding quality audits on each coder • Review 100% of new staff coding until preset quality standards are met • Audit autocoding clinics for documentation accuracy and correct diagnosis assignment • Design and implement coding and billing audits for high-risk compliance areas based on RACs, OIG workplans, public profile sites, and other risk indicators • Prepare audit reports and recommendations for improvement • Analyze coding data to identify variations and their causes; present findings to Corporate Coding leadership • Provide input to coding managers on coder quality for annual evaluations • Assist with internal and external investigation reviews • Perform code-based charge audits and monitor government and third-party billing requirements • Research and appeal payer payment denials within designated timelines • Analyze NCCI edit patterns and assist facilities with process improvement initiatives • Work with the compliance officer to ensure coding and billing law and guideline compliance • Identify documentation improvement and process change opportunities • Collaborate with coding managers and educators to identify training opportunities • Assist in developing coder education and provide training to coders, hospital staff, and physicians on ICD-10-CM/PCS implementation • Compile information for Medical Staff, Medical Records, and Quality meetings • Serve as a resource to Internal Audit staff/RMD on coding and chargemaster issues • Perform other duties as assigned • Maintain current coding knowledge and certification through education, professional journals, and professional organizations

🎯 Requirements

• 5 years IP and OP coding experience • Bachelor's degree with RHIA and CCS; Associates degree with RHIT and CCS • If not current CCS, position contingent on obtaining CCS within 3 months of hire • Extensive knowledge of coding, including inpatient, outpatient, ambulatory surgery, and ER visits • Proficiency with ICD-9 and CPT coding • Knowledge of assignment of DRGs, APCs, and official coding guidelines • CCS certification