Coding Auditor – Educator

🔥 3 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 10%

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WVU Medicine

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • 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

• Educate and train WVU Healthcare coding staff as directed by Coding Managers • Oversee and perform auditing and education plans for coding staff • Perform coding quality audits and provide ongoing feedback and education • Use ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC, and APR-DRG assignment • Manage training activities for designated coding personnel and monitor and report employee development • Manage quality improvement audits and training of designated coding staff • Serve as an expert coding resource to coders, clinical documentation improvement, providers, revenue cycle, specialty groups, and meetings • Act as super user for coding-related electronic medical record systems and support EMR data governance • Update policies, procedures, work queues, and training materials • Communicate with coding staff, medical staff, Physician Advisor, Department Chairmen, and Department Administrators • Organize, facilitate, perform, track, trend, and report internal quality reviews • Design and use audit tools to monitor coding accuracy, documentation gaps, and billing • Coordinate external agency audits, data gathering, exit conferences, and final reports • Coordinate coding/documentation denial reviews and facilitate appeal letter formation • Communicate coding, documentation, audit, and activity issues to Coding Leadership • Ensure completion of audit recommendations, including coding education, coding changes, and rebills • Extract and analyze data and develop action plans when necessary • Assist with onboarding new Coding Specialists • Update Coding Specialists on compliance and regulatory changes • Keep abreast of coding changes, state and federal regulations, and coding resources • Develop curriculum for the WVU Healthcare Coding Certificate Program and support special EMR data governance projects when needed • Utilize systems for curriculum and educational courses, administer exams, and support testing and installation of system upgrades

🎯 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: RHIA, RHIT, COC, CCS, or CPC • Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, MS-DRG, HCC, and APR-DRG assignment, multi-specialty coding, E&M coding, procedural/surgical coding, and governmental billing and coding regulations preferred • Previous supervisory or project management experience preferred • Excellent written, verbal, and interpersonal communication skills • Knowledge of healthcare compliance, revenue cycle operations, and auditing techniques • Ability to mentor, educate, and train others • Ability to ensure quality and productivity standards • Ability to handle high-stress and critical situations calmly and professionally • Ability to maintain accuracy during constant interruptions • Independent decision-making ability • Ability to prioritize job duties and adapt to workplace changes • Organizational and time management skills • Knowledge of anatomy, physiology, and medical terminology • Analytical and problem-solving skills • Proficiency in office software, medical record, and billing systems • Ability to analyze complex data and reports • Ability to sit for long periods, operate computer and office equipment, and lift, push, or pull 10–20 pounds • May require travel