HIS OP Coding Quality Auditor

Northside Hospital•Atlanta, GA

1d•Onsite

About The Position

Northside Hospital is an award-winning, state-of-the-art, and continually growing healthcare system. We are seeking a dedicated HIS OP Coding Quality Auditor to join our team. This role is crucial for ensuring the accuracy and timeliness of our coding processes, which directly impacts billing and patient care. The ideal candidate will work under the supervision of the HIS OP Coding Reimbursement/Coordinator, monitoring coding activities, ensuring compliance with software systems, and collaborating with various departments to maintain high standards of medical record documentation and coding quality.

Requirements

Certification in one of the following: Certified Coding Specialist (CCS) or successful completion of CCS exam within 6 months of hire, or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
Two (2) years experience in Acute Care, CPT and ICD-9-CM coding.
One (1) year experience in quality review.
Demonstrates proficiency in Microsoft Office products.
The ability to develop spreadsheets and databases, and import/export files, etc.
Previous experience with encoder software.

Nice To Haves

Certified Coding Specialist (CCS), or Registered Health Information Administrator (RHIA).
Three + years experience in quality review.
Three (3) to five (5) years' experience in Acute Care, CPT-ICD-9-CM codes.
Previous experience with compliance software.
Previous imaging system and/or HBOC products.

Responsibilities

Audits OP accounts including Business Office account hold list, release list and follow up.
Assists with AHRQ review as necessary.
Provides Lexicode with daily reports: D/C lists, Completed Abstract reports and Suspense.
Communicates with clinical departments regarding insufficient documentation on individual accounts.
Assists with Physician Query Process.
Assists with Case Management IP only requests as necessary.
Assists with Decision Support request as necessary.
Assists OP HIS Coding Reimbursement/Coordinator as needed in monitoring coding compliance and appropriate clinical documentation on a case by case basis.
Assists OP HIS Coding Reimbursement/Coordinator as needed in monitoring coding compliance and appropriate clinical documentation on a case by case basis including infusion therapy coding, outpatient surgery/GI procedure diagnosis and procedure coding.
Serves as liaison for various internal and external coding reviews, assists with chart location, and investigates missing medical records and documentation.
Prepares monthly data for compliance, productivity and quality reporting.
Communicate one on one with Lexicode to maintain OP unbilled at established levels.
Works daily with Lexicode to resolve Northside Hospital issues to code individual records i.e., chart location, double numbers.
Participates in educational programs and in-service meetings.
Attends meetings as required.
Performs other related duties as identified.
Works with Business Office program including: Pending, CCI, LMRP, ESA, and Medicaid Precert program.