Sr. Medical Coding Auditor

St. Luke's Hospital - MO•Chesterfield, MO

2d•Onsite

About The Position

Serves as a lead analyst for the St. Luke’s Hospital 3M 360 Encompass coding system and other coding quality systems. Responsible for development, re-engineering, and system enhancement projects. Performs system and/or staff audits across outpatient hospital and/or ambulatory coding. Maintains databases, spreadsheets, computer and paper files related to coding activities and regulations. Responsible for reporting and proactive analytical support related to coding and reimbursement systems. Responsible for ensuring that systems are designed for optimal and pliant code assignment, including building/maintaining system code sets and tables. Troubleshoot system/program issues and ensure accuracy and efficiency of work flow. Works effectively with physicians, medical group managers and staff, Patient Financial Services, Information Services, Health Information Services, clinical departments, Finance, third-party payers, vendors and other external customers to resolve issues and optimize processes in a professional manner. Responsible for development of user training manuals and performing coding related training of physicians, office staff, and hospital staff. Resource for extensive analytical projects related to coding and charge assignment in the acute outpatient and ambulatory settings. Proficient in the use of a variety of reporting tools including 3M, Cerner, coding edit and chargemaster software systems. Uses reporting capabilities to assist in decision making with process implementation or improvements. Responsible for promoting teamwork with all members of the healthcare team. Performs duties in a manner consistent with St. Luke’s mission and values.

Requirements

Associate’s degree in health services discipline with formal HIM education
3 years of relevant experience.
National certification as RHIA or RHIT are required.

Nice To Haves

Experience with APC, OPPS, RVU, Medicare risk adjustment, Hierarchical Condition Categories, coding, billing, auditing
Current certification in clinical documentation improvement (CCDS, CDIP), or certification in medical coding and or risk adjustment (i.e. CRC, CPC, CCS, or CCS-P or other pertinent to outpatient) preferred.

Responsibilities

Serves as a lead analyst for the St. Luke’s Hospital 3M 360 Encompass coding system and other coding quality systems.
Responsible for development, re-engineering, and system enhancement projects.
Performs system and/or staff audits across outpatient hospital and/or ambulatory coding.
Maintains databases, spreadsheets, computer and paper files related to coding activities and regulations.
Responsible for reporting and proactive analytical support related to coding and reimbursement systems.
Responsible for ensuring that systems are designed for optimal and pliant code assignment, including building/maintaining system code sets and tables.
Troubleshoot system/program issues and ensure accuracy and efficiency of work flow.
Works effectively with physicians, medical group managers and staff, Patient Financial Services, Information Services, Health Information Services, clinical departments, Finance, third-party payers, vendors and other external customers to resolve issues and optimize processes in a professional manner.
Responsible for development of user training manuals and performing coding related training of physicians, office staff, and hospital staff.
Resource for extensive analytical projects related to coding and charge assignment in the acute outpatient and ambulatory settings.
Proficient in the use of a variety of reporting tools including 3M, Cerner, coding edit and chargemaster software systems.
Uses reporting capabilities to assist in decision making with process implementation or improvements.
Responsible for promoting teamwork with all members of the healthcare team.
Performs duties in a manner consistent with St. Luke’s mission and values.