[Hiring] Health Information Auditor @Saint Francis Health System

Role Description

The Health Information Auditor ensures that coding specialists are well-trained and up-to-date on rapidly changing regulatory requirements affecting coding compliance and hospital reimbursement. The auditor ensures coding data quality, accuracy, and timeliness of submission to data repositories at the state, federal, and hospital levels. The auditor must maintain an up-to-date knowledge of all coding rules and guidelines and serves as a liaison with Patient Access and Patient Billing Services. The auditor is responsible for ongoing and continuous monitoring of the quality of all coded data, performing monthly focused audits on all coders and ensuring that a 95% accuracy rate is maintained.

Qualifications

• High School Diploma or GED required.
• Certified Coding Specialist (CCS) required for facility coding or Certified Professional Coder (CPC) for professional coding.
• Certified Professional Medical Auditor (CPMA) preferred.
• 8 years related experience.
• Ability to utilize related software and computer/PC skills.
• Advanced knowledge of coding.
• Excellent interpersonal, written, and oral skills.
• Ability to analyze data and produce reports using MS Office.

Requirements

• Audits randomly a % of each coder's work monthly, ensuring accuracy and compliance.
• Audits focus DRGs as determined by outcomes to ensure compliance with regulatory standards.
• Ensures timely submission of all coded accounts affecting hospital reimbursement.
• Researches outstanding accounts and works to ensure completion.
• Assigns and monitors Educode modules, ensuring that each coder completes assigned lessons.
• Trains and orients new coders to the team.
• Assists with physician queries for documentation.
• Reviews pertinent reports such as monthly POA and produces individual and cumulative monthly quality reports.
• Educates coders on LCD's, clinical coding guidelines, and other regulatory guidelines.

Benefits

• EOE Protected Veterans/Disability