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Senior Coding Quality Auditor

Company: Providence Health & Services
Location: Irvine
Posted on: June 8, 2021

Job Description:

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 responsibilities:

  • 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 requirements.

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 coding staff.
  • 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 updates/information.
  • 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 productivity standards.
  • 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 coding experience

Preferred qualifications for this position include:

  • Associate/Bachelor's Degree in Health Information Management
  • 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 expertise.

Keywords: Providence Health & Services, Irvine , Senior Coding Quality Auditor, Other , Irvine, California

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