Professional Coding Auditor, Educator

🔥 0 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 or perform overall 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 coding references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment • Manage activities of designated coding personnel in training and monitor and report employee developmental activity • Manage quality improvement audits and training of designated coding staff • Act as expert coding resource for coders, clinical documentation improvement, providers, revenue cycle, specialty groups and meetings • Act as super user for coding-related electronic medical record systems; update policies and procedures and in-service staff on changes • Develop and maintain coding policies, procedures, query development, work queues and training materials with management • Communicate with Coding Staff, Medical Staff, Physician Advisor, Department Chairman and Department Administrators • Organize, facilitate, perform, track, trend and report internal quality reviews • Design and use audit tools such as ROC to monitor coding accuracy, documentation gaps and billing • Coordinate outside-agency audits, act as liaison with HIM personnel, facilitate exit conferences and provide final reports to the Coding Manager • Coordinate coding/documentation denial reviews and facilitate appeal letter formation • Communicate with Coding Leadership regarding activities, problems, coding or documentation issues and pending audits • Ensure internal and external audit recommendations are completed, including coding education, coding changes and rebills • Extract and analyze information from various sources and develop action plans when necessary • Assist with onboarding new Coding Specialists regarding coding/quality policies, audits and initiatives • Update Coding Specialists on compliance and regulatory changes • Keep abreast of coding changes, state and federal regulations and coding resources such as Coding Clinic • Potentially develop and design curriculum for the WVU Healthcare Coding Certificate Program and other EMR Data Governance projects; utilize systems, administer exams and support testing and installation of system upgrades • May require travel

🎯 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: RHIA, RHIT, COC, CCS, or CPC • Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, MS-DRG, HCC and APR-DRG assignment; positions and multi-specialty coding; E&M coding; procedural/surgical coding; and governmental billing and coding regulations including the “Teaching Physician Guidelines” preferred • Previous supervisory or project management experience preferred • 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 • Must possess excellent written and verbal communication skills and interpersonal skills • Must possess knowledge of provider healthcare compliance, revenue cycle operations, and auditing techniques • Must be able to mentor, educate and train others • Must ensure quality and productivity standards • Must be able to handle high stress and critical situations in a calm and professional manner • Must be able to concentrate and maintain accuracy during constant interruptions • Must possess independent decision-making ability • Must possess the ability to prioritize job duties • Must be able to adapt to changes in the workplace and work assignments • Must possess organizational and time management skills • Must possess knowledge of anatomy, physiology and medical terminology • Must possess analytical and problem-solving skills • Must be proficient in office software programs, including medical record and billing systems • Must possess the ability to analyze complex data and reports

🏖️ Benefits

• Full-time schedule of 40 hours per week • Exempt status