HIS Inpatient Coding Quality Auditor

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

Under the supervision of the HIS IP Coding Quality Supervisor, the IP Coding Quality Auditor is responsible for conducting pre-bill and retrospective audits on coded accounts based on rules in our Audit and Compliance Module. The HIS IP Coding Quality Auditor also assists the IP HIS Coding Reimbursement/Coordinator in monitoring daily discharge data for coding compliance and ensuring IP discharges are audited within acceptable turnaround times.

PRIMARY DUTIES AND RESPONSIBILITIES

1. Performs pre-bill audits daily, using the Audit and Compliance Module
2. Performs ad-hoc retrospective audits when needed
3. Provides professional, respectful, and meaningful feedback back to the coders
4. Reviews CDI discrepancies and provides supporting evidence from the medical record in explaining the reason for the discrepency
5. Reviews the "Answered CDI clarifications Post-Discharge" report and makes revisions to the account based on physician response.
6. Submits accounts for re-bills, following the standard rebill process
7. Assists with Physician Query Process.
8. Assists IP HIS Coding Reimbursement/Coordinator as needed in monitoring coding compliance and appropriate clinical documentation on a case by case basis.
9. Serves as liaison for various internal and external coding reviews.
10. Participates in educational programs and in-service meetings.
11. Attends meetings as required.
12. Works collaboratively with CDI and the Quality Data Abstractors on identifying missed coding opportunities.
13. Assists with new coder audits and training.
14. Performs other related duties as identified.
15. Participates in providing CDI education / feedback.

REQUIRED:

1. Certification in one of the following: Certified Coding Specialist (CCS) or successful completion of CCS exam within 1 year of hire, or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
2. Two (2) years' experience in Acute Care and ICD-10-CM coding.
3. One (1) year experience in quality review.
4. Demonstrates proficiency in Microsoft Office products. The ability to develop spreadsheets and databases, and import/export files, etc.
5. Previous experience with encoder software.

PREFERRED:

1. Certified Coding Specialist (CCS), or Registered Health Information Administrator (RHIA).
2. Three + years' experience in quality review.
3. Three (3) to five (5) years' experience in Acute Care, ICD-10-CM codes.
4. Previous experience with compliance software.