Coding Quality Auditor and Specialist

This is a fully remote position, open to applicants in Florida, +6 more states.

📋 Description

• Collaborates with the clinical documentation team to review inpatient accounts, focusing on mortality reviews to identify opportunities for documentation improvement.

• Evaluates DRG, PDx, secondary Dx, PCS, POA, and all other documentation components that influence quality metrics.

• Ensures that coding practices adhere to established coding guidelines and regulations consistently.

• Continuously seeks educational opportunities related to coding and documentation.

• Acts as an expert educator for clinical teams and medical staff.

• Identifies strategic initiatives that positively impact the clinical dashboard.

• Cultivates clinical relationships throughout the health system to secure interdepartmental support for the effective implementation of educational strategies, ensuring the achievement of overall strategic goals.

• Capable of multitasking various audits.

• Proficient in data analysis and the development of suitable action plans.

• Creates teaching tools aimed at promoting quality outcomes.

• Actively participates in clinical and executive meetings as assigned.

• Possesses an advanced understanding of quality metrics within the health system (e.g., Vizient, PSI, USNWR).

• Holds an advanced understanding of clinical documentation and coding from the perspective of local and national quality and ranking methodologies, including but not limited to U.S. News and World Report, Vizient, Leapfrog, the CMS Star Rating, and payer contracts, while assisting the Managers of Clinical Documentation and Coding in implementing key strategies for change.

• Collaborates with Coding, Clinical Documentation leadership, and Medical Directors to manage, maintain, and execute advanced project work, which includes Mortality Review, HAC/PSI Review, Quality Abstraction and Analysis, and/or other special and non-traditional projects.

• Works with NM departments, including but not limited to IT, Analytics, and Innovation, to design and implement new and advanced workflow solutions.

• Partners with third-party consultants and partners to contribute to and refine workflow and methodology as needed.

⛳️ Requirements

• RHIT, RHIA, or CCS Certification.

• Certified Clinical Documentation Specialist.

• Bachelor’s Degree in a healthcare-related field or an Associate's Degree combined with over five years of healthcare coding experience.

• Clinical expertise and understanding gained from prior experience with clinical documentation teams.

• Strong personal computer skills, including proficiency in Word, Excel, PowerPoint, and Visio.

• Exceptional verbal, written, and presentation skills.

• Demonstrates critical thinking capabilities.

• Excellent interpersonal abilities.

• Proficient planning and time management skills.

• Experience in educational and training roles.

🏝️ Benefits

• Tuition reimbursement.

• Loan forgiveness.

• 401(k) matching.

• Lifecycle benefits.