[Hiring] Lead HIM Hospital Coder/Auditor @The University of Kansas Health System

Role Description

The Health Information Management (HIM) Inpatient/Observation Hospital Coder Auditor/Lead responsibilities include:

• Reviewing all diagnosis and procedural coding in ICD-10-CM/PCS for accurate DRG assignment.
• Daily interactions with internal and external customers including physicians, hospital support services, and ancillary departments.
• Performing inpatient/outpatient coding compliance audits and providing coder education.
• Assisting in the preparation and finalization of auditing reports.

Responsibilities and Essential Job Functions:

• Must be able to perform the professional, clinical and/or technical competencies of the assigned unit or department.
• Monitors coding compliance and case mix comparison for select outpatient, same day surgery, and inpatient accounts.
• Works with the Clinical Documentation Improvement (CDI) team for comprehensive medical record documentation.
• Validates HIDI, KHA, and other external data reporting accuracy.
• Completes focused record reviews based on benchmarking data from UHC and other quality reports quarterly.
• Identifies unspecified diagnosis and determines if documentation supports a more specific diagnosis.
• Works with Coding Supervisor/Manager on record review projects.
• Provides coding expertise for data reporting activities while adhering to federal regulations and coding guidelines.
• Provides education/training to physicians and other providers on coding and DRG assignment.
• Reviews complex medical records and accurately codes primary/secondary diagnoses and procedures using ICD-10-CM/PCS coding conventions.
• Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes, and surgical techniques.
• Provides high-level analysis of trends to Management, Revenue Managers, and others about coding-related issues.
• Researches and identifies trends in unbilled accounts.
• Coordinates quality reporting measures with Providers, Revenue Managers, and Management.
• Assists supervisor in training new hires and other coders within the department.
• Performs audits on coding accuracy and/or DRG assignment to comply with corporate compliance responsibilities.
• Prepares materials for presentation for continuing education to applicable internal and external customers.

Qualifications

• Associates Degree in related field of study from an accredited college or university.
• 5 or more years of coding experience in inpatient and/or outpatient ICD-10 CM/PCS.
• 1 or more years of auditing experience utilizing ICD-10 CM/PCS.

Requirements

• Bachelors Degree in related field of study from an accredited college or university (preferred).
• Epic experience (preferred).
• CIRCC, CCS-P or RCCB certification (preferred).
• Fluent English - Must be able to read, write, and speak English.
• Expertise in MS-DRG Optimization, APR DRG, RAC/HAC/Core Measures.
• Coding accuracy: 95% or better in accordance with HIM Quality Analysis Policy.

Company Description