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Coding Auditor, Trainer, Educator And Mentor (Remote) Job in Pittsburgh, Pennsylvania

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Job Title: Coding Auditor, Trainer, Educator And Mentor (Remote)

Employer:Diskriter, Inc
Type:Salaried Full-Time
Skills:Coding,Auditing,billing,compliance,Reimbursement,Training,Denial,Appeal,Ability to work from Home,Remote
Specialties:Outpatient,Inpatient
Required Certifications:RHIT,CPC or CCS or RHIA
Preferred Certifications:RHIT,CPC or CCS or RHIA
Required Experience:5 to 7 years
Preferred Experience:5 to 7 years
Location:Pittsburgh, PA
Date Posted:8/10/2018

Company Description: 

Diskriter, headquartered in Pittsburgh, Pennsylvania was established in 1947. Diskriter is a Health Information Management solutions provider, serving clients across the United States since 1947. For the past 71 years, Diskriter has continually provided innovative and technology driven Health Information Management solutions to the healthcare industry. We have helped a broad range of HIM clients determine best practices within each of several areas of emphasis: pure dictation, pure transcription, integrated dictation and transcription systems and services, personnel management, compensation and cost analysis, quality of documentation, workflow analysis and design, coding (acute care, psych, rehab, and LTAC), compliance auditing, RAC readiness, coder and clinician education and training, assembly and analysis, and best-practice benchmarking.

Job Summary:

Perform all related internal and external coding audit activities. Codes and abstracts client's medical records to determine data quality and accuracy of coding, billing and documentation related to DRG's, APR DRG’s, APC's, CPT and HCPCS Level II code and modifier assignments, ICD-10 diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. This position involves ICD-10 Auditing and Training of all current and future Coders, ICD-10 Client, Physician Training, Coding Policies and Procedures, Auditing feedback and Education to the team, developing best practices (manuals, modules, etc.), and general day-to-day operations of the Contracted Services and Consulting Services. Travel to Client sites, Diskriter’s Headquarters will be required on an as-needed basis. Report findings and communicate results to the team as well as Management. Use information to generate topics for client education, training, process changes, risk reduction, optimization of reimbursement. Audit coders' performance on a regular and continuous basis. Prepare and distributes audit results/reports for the system coding compliance program. Identify trends and educational opportunities and assists with training. Prepare and present educational programs related to coding. Assist with other audits as requested. Serve as a knowledge expert and maintains up-to-date working knowledge of coding guidelines in order to act as resource and point person for issues and question for coders, customers and project teams. Coordinate and direct the day-to-day coding educational activities. Facilitate and provide coding educational classes/documents/presentations to staff on an ongoing basis. Responsibilities also include doing root cause analysis of coding quality issues, performing account reviews, and preparing training documents to assist with coding quality action plans. This position also requires performing job responsibilities in a timely fashion; to personally represent the Company and uphold its standards; to adhere to all Diskriter Policies and Procedures; and to assist in setting the standards of excellence for service and support in HIM division.

Job Responsibilities:

Ø  Review inpatient as well as outpatient charts for accurate and timely coding that is supported by medical record documentation and is in accordance with clients' Facility and Official Coding Guidelines.

Ø  Provide guidance on documentation requirements, queries, and documentation improvement processes.

Ø  Communicate audit findings to coding staff, including applicable references, as appropriate.

Ø  Perform auditing functions including monitoring, coding of diagnosis, reviewing medical record documentation and discharge summaries to determine if appropriate code was assigned to ensure compliance with clients specification and coding standards.

Ø  Provide coding related support to internal staff.

Ø  Compile and report statistical data to management and customers.

Ø  Review, develop and deliver training programs and educational materials to address deficiencies identified in the internal coding audits as well as client audits.

Ø  Participate with management in the assessment of audit findings and interact with coders to resolve issues.

Ø  Provide guidance to clients in response to external coding audits conducted and help them in determining appeal action, preparing appeal letter follow up and identifying education issues.

Ø  Develop audit detail summary reports and address any coding, documentation, financial impact and profitability as a result of audits.

Ø  Conduct education/training presentations of final audit findings to internal coders, client’s staff, physicians and appropriate individuals.

Ø  Validate the ICD-10 CM, ICD-10 PCS, CPT and HCPCS Level II codes and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements.

Ø  Provide or arrange for education/training of coders and other healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology and disease processes as it relates to the DRG/APC and other clinical factors.

Ø  Based on coders profile and their performance design and implement coder specific training program.

Ø  Code, Audit charts and provide feedback, Education and Training to coding staff as on a routine basis.

Ø  Respond to coding-related questions from coding staff.

 

Ø  Perform account reviews for denials and appeals.

Ø  Create response, report for denials and help client appeal wherever required.

Ø  Design education plans and education material content

Ø  Review and interpret client’s medical information, classify that information into the appropriate payer specific groups consisting of ICD-10 CM ICD-10 PCS and CPT codes for diagnoses and procedures and calculate the DRG and APC.

Ø  Perform other duties as assigned or required including performing audits and research related to special projects.

 ESSENTIAL JOB FUNCTIONS:

 

Ø  Strive to meet and exceed Company production/quality and turnaround time minimums.

Ø  Create an atmosphere of accepting all others; treats co-workers with dignity and respect; builds positive, productive work relationships for self as well as others in the team.

Ø  Maintain excellent attendance and punctuality. Adhere to pre-approved work schedule. Do not abuse the privilege of “flexing”.

Ø  Adjust schedule accordingly as client and Coder needs change.

Ø  Assist in any functions that are in need of assistance.

Ø  Required to perform Coding and Auditing work based on operational needs.

Ø  Maintain and work to attain client satisfaction.

Ø  Enforce all Coding policies and procedures.

Ø  Research and utilize programs as needed for training and education of staff and clients.

Ø  Attend, facilitate and participate in meetings.

Ø  Create and update training manuals for Coders and other Auditors.

Ø  Ensure projects are completed on time and in scope.

Ø  Provide subject matter expertise.

 EDUCATION AND EXPERIENCE:

Ø  CPC or CCS or RHIA, RHIT certification required.

Ø  Certifications (ICD-10 Trainer, etc) are a plus and encouraged.

Ø  Experience in reimbursement, Denials and Appeals processing are a plus and encouraged.

Ø  Passionate trainer with training expertise is must and skills includes identifying coding training opportunities; developing training plans and material, and instruction/delivery of the training to medical coder and clinical audiences.

Ø  Minimum of 5 years of Coding, Auditing experience in hospital coding and/or auditing, as well as, education techniques and methods is required. In-depth knowledge of ICD10- CM, ICD-10 PCS and CPT, HCPCS coding systems is required.

Ø  Minimum of one to two years of coding auditing experience with a strong background in inpatient and outpatient coding and reimbursement is required.

Ø  Experience in HIM with a focus on revenue cycle, coding, medical records management, work flow, and process is required.

Ø  Extensive ICD 10 knowledge as well as reimbursement methodologies.

Ø  Strong knowledge of both inpatient as well as outpatient coding is required. Must be proficient in DRG/APC structure, National Correct Coding Initiatives, ICD-10 CM/PCS Official Guidelines, Outpatient Prospective Payment System and Coding Clinic References.

Ø  Current working knowledge of encoder, grouper, abstracting and other related software.

Ø  Attention to detail, Strong analytical and communication skills are required.

Ø  Past auditing and strong education/training background in coding and reimbursement preferred.

Ø  Experience and knowledge of healthcare informatics is desirable. Experience in an acute care health information management setting is required including policy development and implementation.

Ø  Work successfully with clients in all healthcare settings.

Ø  Must be Goal oriented.

Ø  Work independently and under pressure with time constraints and deadlines.

Ø  Excellent written and oral communication skills, both listening and speaking; presentation skills are required.

Job Location:  Remote, AA (Work from home/Remote)



Applying

If you are interested, please apply with your resume at jobs@diskriter.com

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