Coding Auditor – Educator

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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

• 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 and assures the monitoring and reporting of respective employee’s developmental activity • Manages quality improvement audits and training of designated coding staff • Acts as expert coding resource to coders, clinical documentation improvement, providers and revenue cycle, specialty groups and meetings • Acts as Super user for all Coding-related Electronic Medical Record Systems necessary for complete and accurate coding and EMR Data Governance • Develops and maintains coding related policies, procedures, query development, work queues and training materials in conjunction with management • Communicates with Coding Staff, Medical Staff, Physician Advisor, Department Chairman, and Department Administrators • Organizes, facilitates, performs, tracks, trends, and reports on internal quality reviews • 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 • Coordinates coding/documentation denial reviews and facilitates appeal letter formation • Communicates regularly with the Coding Leadership on activities, problems, coding and/or documentation issues and pending audits • Ensures audit (external and internal) recommendations are completed (i.e. coding education, coding changes, rebills) • Extracts and analyzes from various sources then develops action plan when necessary • Assist with on-boarding of new Coding Specialists in regard to coding/quality related policies, audits and initiatives • Updates Coding Specialists on compliance and other regulatory changes • Keeps abreast of coding changes, state and federal regulations and coding resources (i.e. Coding Clinic)

🎯 Requirements

• Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience • Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience • 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

• Must be able to sit for long periods of time • Must have visual and hearing acuity within the normal range • Must have manual dexterity needed to operate computer and office equipment • Must be Able to lift, push or pull 10-20 pounds • Standard office environment • Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material • May require travel