Senior Coding Quality Auditor
Company: Pacific Medical Centers
Posted on: May 3, 2021
Providence St. Joseph Health is calling a Senior Coding Quality
Auditor (Full-Time, Days) to our location in Irvine, CA.
We are seeking a Senior Coding Quality Auditor to perform
quality analysis of ICD and CPT codes as well as MS-DRG and APC
assignment to all patient account types according to American
Hospital Association (AHA), Uniform Hospital Discharge Set (UHDDS),
and American Medical Association guidelines. This individual will
evaluate codes on a pre-set audit cycle, assign scores according
based on predetermined audit criteria, and provide feedback to
coding management and staff. In addition, the Quality Auditor is
responsible for trending coding related issues, identifying
training needs, and completing training delivery as necessary.
In this position you will have the following
- Conduct monthly audit reviews on inpatient and outpatient
records to validate ICD and CPT coding, MS-DRG/APC appropriateness,
missed secondary diagnoses, and/or procedures, POA and discharge
dispositions, and ensure compliance with all MS-DRG/APC reporting
Act as a knowledgeable resource on Registration and Financial
Clearance functions for department staff. (e.g., answer account
questions, assist with new staff training, etc.)
- Responsible for the training, coaching, and appraising of the
- Responsible for updating Manager/Director with issues,
concerns, and topics of interest related to assigned areas.
- Code a variety of patient charts that may include inpatient,
outpatient, clinic and/or ER, meeting all regulatory guidelines and
standards applicable in the coding industry as needed.
- Monitor and assist coders and CDS staff with CDI
- Maintain up to date knowledge of the current changes of coding
practices by continuing education seminars/ classes and reading
materials, such as Coding Clinic, Official Guidelines, etc.
- Meet all regulatory guidelines and standards applicable in the
coding industry and reaching and maintaining department set
- Attend department meetings and attend/read all education
workshops, Coding Round Table Meetings, or any other required
meetings as determined by the Coding Manager.
- Provide advisory on code selection and answer coding questions
posed by physicians and SJHS employees.
- Follow SJHS compliance coding policies and guidelines.
Required qualifications for this position include:
- High school diploma or equivalent
- Certification as a Registered Health Information Administrator
(RHIA), Registered Health Information Technician (RHIT), or
Certified Coding Specialist (CCS)
- 3 or more years of CPT and/or ICD-9-CM acute care hospital
Preferred qualifications for this position include:
- Associate/Bachelor's Degree in Health Information
- AHIMA certified coding program
- Previous Audit experience
- Experience in other clinical or healthcare disciplines
About the department you will serve.
One Revenue Cycle (ORC) is the name adopted to reflect the
Providence employees who work throughout Providence Health &
Services (PH&S) in revenue cycle systems and structures in
support of our ministries and operations in all regions from Alaska
to California. ORC's objective is to ensure our core strategy, One
Ministry Committed to Excellence, is delivered along with the
enhanced overall patient care experience (know me, care for me,
ease my way) by providing a robust foundation of services,
operational and technical support, and the sharing of
comprehensive, relevant, and highly specialized revenue cycle
Keywords: Pacific Medical Centers, Irvine , Senior Coding Quality Auditor, Other , Irvine, California
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