Role Description
As our Revenue Cycle Auditor-Educator Coding you will leverage your expert knowledge of current ICD (diagnostic and procedural) and CPT-4 coding classification systems in this advanced-level position. This pivotal role is responsible for ensuring the highest standards of coding accuracy and compliance across our organization, directly impacting revenue cycle integrity and patient care documentation.
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Be the go-to resource for answering complex coding and billing questions.
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Play a key role in the onboarding and training of new staff.
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Perform critical coding/DRG validation audits.
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Lead the development and deployment of comprehensive coding and CDI (Clinical Documentation Integrity) education programs.
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Plan and execute system-wide training in conjunction with the coding and CDI leadership team.
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Conduct internal audits with follow-up education.
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Facilitate the standardization of best practices.
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Monitor and communicate regulatory coding and billing changes for timely and accurate implementation.
To be successful in this role, you will need a deep understanding of healthcare coding guidelines (ICD-10, CPT-4), DRG validation, and revenue cycle best practices. We are seeking a highly analytical and articulate professional with proven experience in coding education, auditing, and compliance.
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Act as a liaison between CDI, physicians, clinical quality, and patient financial services.
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Foster collaborative relationships to ensure the utmost accuracy and integrity of the inpatient medical record.
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Compliance & Standards:
Ensures coding/CDI practices adhere to compliant and regulatory requirements, upholding ethical standards (AAPC/AHIMA).
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Productivity & Workflow:
Monitors work queues/worklists to meet KPIs, productivity, and accuracy standards, and identifies complex issue resolutions.
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Cross-functional Collaboration:
Acts as a liaison with various departments (CDI, PFS, Patient Registration, Clinical Staff) to resolve problems and improve workflow.
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Strategic Planning & Leadership:
Assists leadership in strategic planning, communicates effectively, delivers presentations, and demonstrates strong leadership.
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Continuous Improvement:
Identifies training needs, collaborates on audit results and education, and develops/executes process improvement projects.
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Resource Management & Environment:
Assesses tools to prevent errors/denials, promotes a professional/team-oriented environment, and provides remote computer troubleshooting.
Qualifications
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Associateโs degree in HIM/related field or Associateโs degree in Nursing.
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4-6 years performing coding CDI audits and education in large multifacility healthcare systems.
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Certification from AHIMA (CCS, RHIT, RHIA, CDIP), AAPC (CIC) and/or ACDIS (CCDS) to be maintained.
Requirements
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4-6 years performing coding CDI audits and creating education sessions in large multifacility healthcare systems.