InPatient Coding Quality Auditor
Employment Type: Full-Time
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Description Inpatient Coding Quality Audito
r AdventHealth Tampa
Location Address: 3100 East Fletcher Avenue Tampa, Florida 33613 Top Reasons to Work at AdventHealth Tampa Florida Hospital Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment and research. Surgical Pioneers – the first in Tampa with the latest robotics in spine surgery Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come Awarded the Get With The Guidelines – Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center. Work Hours/Shift:
Full Time- Remote You Will Be Responsible For: Reviews records for DRG and overall coding accuracy retrospectively and concurrently at Florida Hospital’s West Florida Region. Reviews and addresses all third party/Regulatory Agencies requests for DRG changes or quality studies. Reviews monthly pre-bill accounts for coding accuracy and reporting to Corporate for scorecard. Codes and abstracts charts in accordance with ICD-10-CM conventions, applying coding rules applicable to Florida Hospital Tampa Division and requirements of Medicare and payor specifications. Assign DRGs on chart in accordance with all UHDDS rules, ICD-10 Coding Conventions and approved coding policies and procedures. Assist with timely interaction between departments to resolve issues. Mentor and educate other coders. Discuss optimization and documentation issues with appropriate clinical physicians and personnel to ensure optimal coding and reimbursement querying physicians for the clarification or addition of diagnosis, complications or co-morbid conditions present on as needed basis. Abides by the Standards of Ethical coding as set forth by American Health Information Management Association (AHIMA). Queries physicians when code assignments are not straightforward or documentation in the record is inadequate. Reviews payer denials in accordance with the denials process. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate. Reviews payer denials in accordance with the denials process. Maintains productivity standards per hospital policy. Maintains 98% accuracy rate. Assists manager in maintaining goals for accounts discharged not final billed. Assists in reviewing and correcting any information for the Agency for Healthcare Administration (AHCA). Reports non-compliance issues detected through auditing and monitoring to manager. Keeps abreast of coding guidelines and reimbursement reporting requirements and brings identified concerns to manager for resolution. Maintains a current knowledge of ICD-10-CM/PCS coding updates and changes through Coding Clinics and seminars, as well as changes in the Medicare/Insurance industry. Uses the Optum coding software; ICD-10-CM code books and Coding Clinics sources per established coding principals and guidelines. Works 72-hour report as assigned.
Qualifications What You Will Need:
EQUIPMENT USED : Computer, Optum Encoder, Dolbey, laser printer, fax machine, copy machine
SUPERVISION RECEIVED AND GIVEN : Supervision received from Inpatient Coding Manager EDUCATION AND EXPERIENCE
: Minimum of 3 years’ experience coding Medicare inpatient records (required) Graduation from an accredited RHIT, RHIA and CCS program (required)
CERTIFICATES, LICENSURES AND REGISTRATION : CCS required. RHIA/RHIT preferred.
GENERAL SUMMARY :
The Coding Quality Auditor, under the general supervision of the Inpatient Coding Operations Manager, is responsible for the internal coding audit and clinical quality reviews. The Coding Quality Auditor will work in conjunction with the Inpatient Operations Manager to ensure the integrity of coded data, the education and training of the coding staff, as well as being a resource to the entire organization on issues related to coding data. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
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