Professional Coding Auditor, Educator

This is a fully remote position, open to applicants in United States.

📋 Description

• Provide education and training to the WVU Healthcare Coding Staff as instructed by Coding Managers.

• Oversee or implement comprehensive auditing and education plans for the Coding team.

• Conduct coding quality audits and offer continuous feedback and education.

• Utilize ICD-10-CM, ICD-10-PCS, CPT, and other coding resources and software to guarantee accurate coding and MS-DRG, HCC, and APR-DRG assignment.

• Supervise the activities of designated coding personnel in training while monitoring and reporting on employee developmental progress.

• Manage quality improvement audits and training for designated coding staff.

• Serve as an expert coding resource for coders, clinical documentation improvement, providers, revenue cycle, specialty groups, and meetings.

• Act as a super user for coding-related electronic medical record systems; update policies and procedures, and provide in-service training for staff on changes.

• Develop and maintain coding policies, procedures, query development, work queues, and training materials in collaboration with management.

• Communicate effectively with Coding Staff, Medical Staff, Physician Advisors, Department Chairpersons, and Department Administrators.

• Organize, facilitate, conduct, track, trend, and report on internal quality reviews.

• Design and implement audit tools such as ROC to assess coding accuracy, documentation gaps, and billing.

• Coordinate external audits, acting as a liaison with HIM personnel, facilitating exit conferences, and providing final reports to the Coding Manager.

• Manage coding/documentation denial reviews and assist in forming appeal letters.

• Liaise with Coding Leadership regarding activities, issues, and pending audits related to coding or documentation.

• Ensure the completion of internal and external audit recommendations, including coding education, changes, and rebills.

• Extract and analyze data from various sources, developing action plans as needed.

• Assist in onboarding new Coding Specialists in coding/quality policies, audits, and initiatives.

• Keep Coding Specialists informed of compliance and regulatory updates.

• Stay updated on coding changes, state and federal regulations, and coding resources such as Coding Clinic.

• Potentially develop and design curriculum for the WVU Healthcare Coding Certificate Program and other EMR Data Governance projects; oversee systems, administer exams, and support testing and implementation of system upgrades.

• Travel may be required.

⛳️ Requirements

• Graduate from a Health Information Technology (HIT) program or equivalent with five (5) years of coding experience; OR a graduate from a Medical Coding Certification Program with five (5) years of coding experience; OR a high school diploma or equivalent with eight (8) years of coding experience.

• Certification in one of the following: RHIA, RHIT, COC, CCS, or CPC.

• Extensive background in ICD-10-CM, ICD-10-PCS, CPT, MS-DRG, HCC, and APR-DRG assignment; experience in positions with multi-specialty coding, E&M coding, procedural/surgical coding, and governmental billing and coding regulations including the “Teaching Physician Guidelines” is preferred.

• Previous supervisory or project management experience is preferred.

• Ability to sit for extended periods.

• Visual and hearing acuity within normal ranges is required.

• Manual dexterity to operate computer and office equipment is necessary.

• Capability to lift, push, or pull weights of 10-20 pounds.

• Excellent written and verbal communication skills alongside strong interpersonal skills are essential.

• Knowledge of provider healthcare compliance, revenue cycle operations, and auditing techniques is required.

• Ability to mentor, educate, and train others is necessary.

• Commitment to ensuring quality and productivity standards is essential.

• Ability to handle high-stress and critical situations calmly and professionally.

• Ability to concentrate and maintain accuracy amidst constant interruptions.

• Independent decision-making ability is required.

• Capacity to prioritize job duties effectively.

• Adaptability to changes in the workplace and work assignments is necessary.

• Strong organizational and time management skills are essential.

• Knowledge of anatomy, physiology, and medical terminology is required.

• Proficient analytical and problem-solving skills are necessary.

• Proficiency in office software programs, including medical record and billing systems, is required.

• Ability to analyze complex data and reports is essential.

🏝️ Benefits

• Full-time schedule of 40 hours per week.

• Exempt status.