[Hiring] Coding Auditor & Education Advisor @Phoebe Putney Health System

Role Description

We are seeking an experienced Acute Inpatient Coding Auditor with recent acute care hospital experience. This role is responsible for auditing facility-based inpatient coding, DRG assignment, ICD-10-CM/PCS coding accuracy, documentation review, and compliance. Candidates must have a strong background in acute inpatient hospital coding and auditing. This position focuses exclusively on facility (hospital) inpatient services and is not a professional fee/physician coding role.

• Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy.
• Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices.
• Educates and trains coders to ensure both a working knowledge of coding and reimbursement guidelines and successful career ladder completion, including the development of training materials and reference documents.
• Researches audit results, error reports, and denials and resolves by successful appeal, staff education, and correction of discrepancies.

Qualifications

• 4 year / Bachelor's Degree in Health Information Management or related medical degree (Required); In lieu of a Bachelor's Degree, an Associate Degree and a Minimum of 4 years additional relevant experience is acceptable.
• 4 - 5 years Experience with ICD-9, ICD-10, and HCPCS coding including hospital inpatient medical records (Required).
• 4 - 5 years Extensive knowledge of medical terminology, pathophysiology, and pharmacology (Required).
• 4 - 5 years Experience calculating and analyzing MS-DRG, DRG, APC, and other payer reimbursement methodologies (Required).

Requirements

• Adheres to the hospital and departmental attendance and punctuality guidelines.
• Performs all job responsibilities in alignment with the core values, mission and vision of the organization.
• Performs other duties as required and completes all job functions as per departmental policies and procedures.
• Maintains current knowledge in present areas of responsibility (i.e., self-education, attends ongoing educational programs).
• Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.

Working Conditions

• General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.
• May be required to change from one task to another of different nature without loss of efficiency or composure.
• Periods of high stress and fluctuating workloads may occur.
• May be scheduled as needed including overtime.

Certifications and Licensures

• Required Certifications/Licensures: Certified Coding Specialist (CCS).
• Preferred Certifications/Licensures: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), AHIMA Approved ICD-10 Trainer.

General Skills

• Organizational Skills
• Communication Skills
• Interpersonal Skills
• Customer Relations
• Mathematical
• Analytical
• Grammar / Spelling
• Read / Comprehend Written Instructions
• Follow Verbal Instructions
• Basic Computer Skills
• Microsoft Office Suite
• General Clerical Skills

Physical Requirements

• Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors.
• Ability to perform repetitive tasks/motion.

Physical Demands

• Standing - Occasionally within shift (1-33%)
• Walking - Occasionally within shift (1-33%)
• Sitting - Continuously within shift (67-100%)
• Bending/Stooping - Occasionally within shift (1-33%)
• Twist at waist - Occasionally within shift (1-33%)
• Pushing/Pulling - Occasionally within shift (1-33%)
• Reaching above shoulder - Occasionally within shift (1-33%)

Additional Information

Phoebe Putney Health System employees are prohibited from working as Remote employees in the following states:

• California
• Colorado
• Connecticut
• Hawaii
• Maryland
• Massachusetts
• Michigan
• Nevada
• New Jersey
• New York
• Oregon
• Rhode Island
• Vermont
• Washington
• Washington D.C.