Coding Audit & Education Coordinator

St. Luke’s University Health Network•Allentown, PA

10d

About The Position

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Coding Audit & Education Coordinator will be responsible for performing internal, concurrent, prospective and retrospective coding audit activities. The incumbent will also review and validate coded medical records of the Professional Coding (PC) staff to determine data quality and accuracy of coding, billing, and documentation related to DRG's, CPT, APC's, and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements.

Requirements

Must maintain and be credentialed in at least ONE of the following AHIMA and/or AAPC recognized Professional Coding Certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS)
In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems.
Must be proficient in DRG/APC structure, National Correct Coding Initiatives, ICD CM/PCS Official Guidelines, Outpatient Prospective Payment System and Coding Clinic References.
Current working knowledge of encoder/grouper.
Strong analytical and communication skills.
5 years of coding experience required.

Nice To Haves

Experience in auditing education techniques and methods preferred, but not required.

Responsibilities

Collaborates with the Network Director of Coding in designing and executing concurrent and retrospective internal audits of hospital PC staff.
Conducts one-on-one education sessions for PCs needing focused attention on audit findings.
In addition, works in conjunction with network Coding Director to provide departmental education to PC staff following each audit conducted.
Develops audit detail summary spreadsheets and reports to track performance of PC staff.
Recognizes trends and works collaboratively to address any coding and documentation issues.
Analyzes coding data audits to identify trends within the hospital system, and identify areas of opportunity or assess potential compliance risks.
Assists with training and onboarding of new PC staff.
Collaborates with management to conduct education/training.
Works with external resources for annual audits and assists to present final audit findings to department staff, physicians and appropriate individuals.
Participates with management in the assessment of external audit findings and responds as needed.
Acts as an administrative liaison between executive leadership, CDI, and the coding teams.