[Hiring] Professional Coding Auditor-Educator @WVU Medicine

Role Description

Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also 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.

Qualifications

• 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)
  • Registered Health Information Technician (RHIT)
  • Certified Outpatient Coder (COC)
  • Certified Coding Specialist (CCS)
  • Certified Professional Coder (CPC)

Requirements

• 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 multi-specialty coding.
• Previous supervisory or project management experience.

Core Duties and Responsibilities

• Manage activities of designated coding personnel in training for WVU Healthcare.
• Manage quality improvement audits and training of designated coding staff.
• Act as expert coding resource for coders, clinical documentation improvement, providers, and revenue cycle.
• Act as Super user for all Coding-related Electronic Medical Record Systems.
• Develop and maintain coding related policies, procedures, query development, work queues, and training materials.
• Communicate regularly with Coding Staff, Medical Staff, Physician Advisor, Department Chairman, and Department Administrators.
• Organize, facilitate, perform, track, trend, and report on internal quality reviews.
• Design and use audit tools to monitor the accuracy of coding, documentation gaps, and billing.
• Coordinate audits performed by outside agencies.
• Coordinate coding/documentation denial reviews and facilitate appeal letter formation.
• Communicate regularly with the Coding Leadership on activities and issues.
• Ensure audit recommendations are completed.
• Extract and analyze data from various sources and develop action plans.
• Assist with onboarding of new Coding Specialists.
• Update Coding Specialists on compliance and regulatory changes.
• Keep abreast of coding changes, state and federal regulations, and coding resources.
• Develop and design the curriculum for the WVU Healthcare Coding Certificate Program if needed.

Physical Requirements

• 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.

Working Environment

• Standard office environment.
• Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material.
• May require travel.

Skills and Abilities

• Excellent written and verbal communication skills.
• Knowledge of related provider healthcare compliance, revenue cycle operations, and auditing techniques.
• Ability to mentor, educate, and train others.
• Ensure quality and productivity standards.
• Handle high stress and critical situations in a calm and professional manner.
• Concentrate and maintain accuracy during constant interruptions.
• Independent decision-making ability.
• Ability to prioritize job duties.
• Adapt to changes in the workplace and work assignments.
• Organizational and time management skills.
• Knowledge of anatomy, physiology, and medical terminology.
• Analytical and problem-solving skills.
• Proficient in office software programs, including medical record and billing systems.
• Ability to analyze complex data and reports.

Additional Job Description

• Scheduled Weekly Hours: 40
• Shift: Exempt
• United States of America (Exempt)
• Company: SYSTEM West Virginia University Health System
• Cost Center: 539 SYSTEM HIM Provider Based Coding Analysis