Coding Auditor – Educator

Role Overview

• Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers.
• Will oversee or perform the overall auditing and education plans for the Coding staff.
• Perform coding quality audits, provide ongoing feedback and education.
• Utilize various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment.
• Manages activities of designated coding personnel in training for WVU Healthcare and assures the monitoring and reporting of respective employee’s developmental activity.
• Manages quality improvement audits and training of designated coding staff.
• Acts as expert coding resource not only to coders, clinical documentation improvement, providers and revenue cycle, but also to specialty groups and meetings.
• Acts as Super user for all Coding-related Electronic Medical Record Systems necessary for complete and accurate coding and EMR Data Governance.
• Updates policies and procedures for those areas of responsibility.
• Develops and maintains coding related policies, procedures, query development, work queues and training materials in conjunction with management.
• Continually communicates with Coding Staff, Medical Staff, Physician Advisor, Department Chairman, and Department Administrators.
• Organizes, facilitates, performs, tracks, trends, and reports on internal quality reviews.
• Designs and uses audit tools (i.e ROC) to monitor the accuracy of coding, documentation gaps, and billing performed by Coding Specialists.
• Coordinates audits performed by outside agencies and facilitates appeal letter formation.

Requirements

• Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR High School Diploma or Equivalent AND Eight (8) years of coding experience.
• Certification in ONE of the following: Registered Health Information Administrator (RHIA) OR Registered Health Information Technician (RHIT) through American Health Information Management Association ) Certified Outpatient Coder (COC) through American Academy of Professional Coders Certified Coding Specialist (CCS) through American Health Information Management Association Certified Professional Coder (CPC) through American Academy of Professional Coders.
• Bachelor’s degree in Health Information Management or related field preferred.
• Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” for Professional Coding Positions preferred.
• Previous supervisory or project management experience.

Benefits

• Standard office environment.
• May require travel.