|Employer:||Providence St. Joseph Health
|Required Experience:||3 to 4 years
|Location:|| Anaheim 92805, CA, US
Sr. Coding Quality Auditor
Providence St. Joseph Health is calling a Sr. Coding Quality Auditor to our location in Anaheim, CA.
We are seeking a Sr. Coding Quality Auditor to assist with the day-to-day operations of the audit department for St. Joseph Heritage Healthcare (SJHH) and multiple divisions. This position will assist with new employee training and ongoing department education as well as assist with the identification, development and delivery of new and ongoing provider education and training related to coding and clinical documentation. In addition, the role conducts independent and collaborative provider audits according to the compliance work plan and develops appropriate documentation to support audit work performed.
The position requires collaboration with various departments e.g., Physician Network Operations, Revenue Cycle, Compliance, Practice Operations, and other key stakeholders necessary to develop and implement training curriculum for prioritized opportunities in assigned departments, lead provider training, analyze and distribute key performance metrics and develop action plans for improvement in collaboration with the provider leadership.
In this position you will have the following responsibilities:
• Provide staff with training and resources on Audit and Education procedures & workflow
• Develop action plans as necessary to resolve knowledge gaps with employees or to address the implementation of new service offerings or code changes
• Facilitate the collection of information to provide feedback to physicians on audit findings to ensure consistency & accuracy with all coding
• Maintain up-to-date knowledge of current auditing/coding practices and educates providers on coding/documentation guidelines to ensure regulatory compliance
• Facilitate education to support Medicare Risk requirements & organization goals
• Analyze patient medical records to identify procedures and physician diagnoses
• Discern relevant patient details from the medical record based on the guidelines
• Audit medical record documentation to identify undercoded and upcoded services; prepare reports of findings and provide provider education and training on accurate coding practices and compliance issues
Required qualifications for this position include:
• Associate’s Degree in related healthcare field
• Valid coding credentials (AAPC/AHIMA)
• One or any combination of the following credentials: CCS, CCS-P, CPC, CEMC, CPMA - REQUIRED
• Four (4) years of professional fee inpatient, surgical, outpatient coding, E/M, auditing and related work
• Four (4) years experience conducting medical coding provider audits and quality performance measures; preparing audit reports with recommendations; and providing provider education and feedback to facilitate improvement in documentation and coding
• Strong typing and computer skills in a Windows environment
Preferred qualifications for this position include:
• Bachelor’s Degree in Management, Health Information Technology, or related field
• Five (5) plus years experience conducting medical coding provider audits and quality performance measures; preparing audit reports with recommendations; and providing provider education and feedback to facilitate improvement in documentation and coding
• Five (5) plus years of professional fee inpatient, surgical, outpatient coding, E/M, auditing and related work preferred
• Certified Healthcare Compliance (CHC), Clinical Documentation Improvement Practitioner preferred
• Current RHIT certification highly desirable
About the department you will serve:
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence St. Joseph health from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
St. Joseph Heritage Healthcare (SJHH) is one of California's most respected medical groups. With over 3,000 employees and 75 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, SJHH has been continually recognized as a leader in quality, customer service and information technology. This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization's mission, vision and values.
St. Joseph Heritage Healthcare (SJHH) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, St. Joseph Heritage Healthcare (SJHH) complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
St. Joseph Hospital is an Equal Opportunity Employer.