Revenue Cycle Auditor-Educator CDI
About The Position
This is an advanced level position with expert knowledge of current ICD (diagnostic and procedural) and CPT-4 coding classification systems. Responsible for answering coding and billing questions, onboarding and training new staff, performing coding/DRG validation audits, and development and deployment of coding and CDI education. Works in conjunction with the coding and CDI leadership team in planning and performing education and training across the system. Responsible for performing internal audits and follow up education. Facilitates and promotes standardization of coding/CDI practices, monitors and communicates regulatory coding and billing changes for timely and accurate implementation. Acts as a liaison between CDI, physicians, clinical quality, patient financial services, and other departments to ensure collaborative relationships resulting in accuracy and integrity of the inpatient medical record. Completes initial medical records reviews within 24-48 hours of admission for a specified patient population to evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality and severity of illness. Conducts follow-up reviews every 2-3 days to support working DRG assignment. Formulates compliant provider queries regarding missing, unclear or conflicting documentation, as necessary. Follows up daily on open queries with providers to ensure timely responses. Reviews final coding DRG assignment follows DRG reconciliation process. Keep abreast of Official Coding and Reporting Guidelines, AHA Coding Clinics, CMS and other agency directives and maintains up to date knowledge of coding and CDI current trends. Strong oral communication skills and the ability to deliver presentations to large groups.
Requirements
- Expert knowledge of current ICD (diagnostic and procedural) and CPT-4 coding classification systems
- Associate's degree in Nursing and/or HIM related fields or 4-6 years of experience
- Five (5) years coding auditing experience including but not limited to hospital inpatient and outpatient encounters, upon hire
- Six (6) years of experience in coding quality audit work or record review including but not limited to hospital inpatient and outpatient, upon hire
- Certified Coding Specialist, upon hire
- Certified Professional Coder, upon hire
- Registered Health Information Administrator, upon hire
- Registered Health Information Technician, upon hire
- Clinical Documentation Improvement Professional, upon hire
- Strong oral communication skills
Nice To Haves
- Other in relevant field or combination of equivalent of education and experience., upon hire
Responsibilities
- Answering coding and billing questions
- Onboarding and training new staff
- Performing coding/DRG validation audits
- Development and deployment of coding and CDI education
- Planning and performing education and training across the system
- Performing internal audits and follow up education
- Facilitating and promoting standardization of coding/CDI practices
- Monitoring and communicating regulatory coding and billing changes for timely and accurate implementation
- Acting as a liaison between CDI, physicians, clinical quality, patient financial services, and other departments
- Completing initial medical records reviews within 24-48 hours of admission for a specified patient population to evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality and severity of illness
- Conducting follow-up reviews every 2-3 days to support working DRG assignment
- Formulating compliant provider queries regarding missing, unclear or conflicting documentation
- Following up daily on open queries with providers to ensure timely responses
- Reviewing final coding DRG assignment and following the DRG reconciliation process
- Keeping abreast of Official Coding and Reporting Guidelines, AHA Coding Clinics, CMS and other agency directives
- Maintaining up-to-date knowledge of coding and CDI current trends
- Delivering presentations to large groups
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Associate degree
