Clinician Services Analyst Senior - Primary Care
Advocate Aurora Health
Coding Auditor / Educator
WVU Medicine
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers
- 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/software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment
- Manage activities of designated coding personnel in training and assure monitoring/reporting of developmental activity
- Manage quality improvement audits and training of designated coding staff
- Act as expert coding resource to coders, clinical documentation improvement, providers, revenue cycle, specialty groups and meetings
- Act as Super user for Coding-related Electronic Medical Record Systems; update policies/procedures and in-service appropriate staff
- Develop and maintain coding related policies, procedures, query development, work queues and training materials in conjunction with management
- 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 (i.e ROC) to monitor the accuracy of coding, documentation gaps, and billing performed by Coding Specialists
- Coordinate audits performed by outside agencies and act as liaison between agency and HIM personnel
- Coordinate coding/documentation denial reviews and facilitate appeal letter formation
- Ensure audit recommendations are completed (coding education, coding changes, rebills)
- Extract and analyze data from various sources then develop action plans when necessary
- Assist with on-boarding of new Coding Specialists regarding coding/quality related policies, audits and initiatives
- Update Coding Specialists on compliance and other regulatory changes
- Keep abreast of coding changes, state and federal regulations and coding resources (i.e. Coding Clinic)
- Potential responsibility for development and design of curriculum for the WVU Healthcare Coding Certificate Program and other EMR Data Governance projects; administer exams and involve in system testing/upgrades
Requirements
- Graduate of Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience
- Medical Coding Certification Program AND Five (5) years of coding experience
- High School Diploma or Equivalent AND Eight (8) years of coding experience
- Certification in one of the following: RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CCS (Certified Coding Specialist), or CPC (Certified Procedural Coder)
- 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
- Experience with Positions and multi-specialty coding, E&M coding, procedural/surgical coding
- Knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” for Professional Coding Positions (preferred)
- Previous supervisory or project management experience (preferred)
- Must possess excellent written and verbal communication skills
- Must possess the knowledge of related provider healthcare compliance, revenue cycle operations, and auditing techniques
- Must possess the ability to mentor, educate and train others
- Must ensure quality and productivity standards
- Must be able to handle high stress and critical situations in a calm and professional manner
- Must be able to concentrate and maintain accuracy during constant interruptions
- Must possess independent decision-making ability
- Must possess the ability to prioritize job duties
- Must be able to adapt to changes in the workplace and work assignments
- Must possess organizational and time management skills
- Must possess the knowledge of anatomy, physiology and medical terminology
- Must possess analytical and problem solving skills
- Must be proficient in office software programs, including medical record and billing systems
- Must possess the ability to analyze complex data and reports
- Physical requirements: sit for long periods of time; visual and hearing acuity within the normal range; manual dexterity to operate computer and office equipment; Able to lift, push or pull 10-20 pounds
- Scheduled Weekly Hours: 40; Shift: Exempt/Non-Exempt: United States of America (Exempt)
