Job Information

Providence Coding QI Compliance Auditor Trainer II, Inpatient *Telecommute* in Montana

Description

Providence St. Joseph Health is calling a Coding QI Compliance Auditor Trainer II to work remotely within our footprint states: AK, CA, MT, OR, TX and/or WA.

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.

The Coding QI Compliance Auditor and Trainer II is critical to the coding compliance program. By performing audits of hospital coding, training new coding staff, preparing and presenting educational sessions for the coders and staying current with official coding guidelines and regulations, the incumbent ensures the proper coding of PH&S hospital medical records. This position includes obtaining, recording and reporting essential data, assisting in problem solving of coding issues and acting as a subject matter expert for coding staff.

Responsibilities:

  • Ensure accurate, compliant coding of hospital medical records through training, auditing and research.

  • Work with coders and CDI specialists to resolve complex coding and documentation issues.

  • Train and mentor new coding staff, keeping manager/supervisor informed as to progress.

  • Act as a subject matter expert for the coding staff.

  • Perform random and focused audits of HIM-coded medical records by reviewing charts for coding accuracy, including DRG or APC, severity of illness and risk of mortality levels. In addition, check the completeness and accuracy of abstracting, including discharge disposition and present on admission indicators. Communicate findings to coders. In cases of disagreement, convene the reviewer committee to review and vote, taking accountability for the final coding.

  • Train and mentor Coding QI Compliance Auditor and Trainer I staff by reviewing work done and providing feedback for growth.

  • Identify and track coding educational needs based on audit results; prepare and present training sessions to coders.

  • Research and answer coding questions, enlisting the assistance of colleagues, including CDS nurses, supervisor or manager as needed.

  • Review RAC coding denials and underpayments and provide rationale for appeals.

  • Assist with coding-related insurance company denials, providing rationale for appeals.

  • Assist with revision of PH&S coding guidelines.

  • Maintain coding skills by coding and abstracting in accordance with national and PH&S coding guidelines.

  • Meet departmental standards for productivity and quality on a consistent basis.

  • Attend and participate in coding section meetings and training sessions.

  • Maintain accurate, clear, concise, and complete account notes and other relevant information.

  • Promote PH&S as a premier service organization by treating customers with compassion and respect.

  • Identify, resolve and escalate major issues and service failures that impede success.

  • Maintain confidentiality of all patients’ demographic, medical, and financial information, ensuring proper handling and disposal of confidential documents and adherence to HIPAA.

  • Comply with all applicable Federal, State, and local laws, regulations, and requirements as well as PH&S policies and procedures in all aspects of job performance.

Required qualifications:

  • Associate's Degree in a healthcare related program with a minimum of one of he following credentials required; Any AHIMA or AAPC coding Credential Or Equivalent combination of education and experience can be considered in lieu of degree

  • Required upon hire: National Certification from American Academy of Professional Coders Or

  • Required upon hire: National Certified Coding Associate - American Health Information Management Association Or

  • Required upon hire: National Certified Coding Specialist - American Health Information Management Association Or

  • Required upon hire: National Certified Coding Specialist - Physician - American Health Information Management Association Or

  • Required upon hire: National Certified Documentation Improvement Practitioner - American Health Information Management Association Or

  • Required upon hire: National Certified Health Data Analyst - American Health Information Management Association (Vendor Managed) Or

  • Required upon hire: National Registered Health Information Administrator - American Health Information Management Association Or

  • Required upon hire: National Registered Health Information Technician - American Health Information Management Association

  • 2 years Recent acute care coding auditing and training.

  • 4 years Recent acute care coding experience in one of the following areas: Hospital inpatient, day surgery or emergency department.

  • A track record in troubleshooting coding quality problems.

  • A track record in reading and interpreting medical records.

  • A track record in organizing and planning with demonstrated ability to effectively manage time and achieve results in a fast paced environment.

Preferred qualifications:

  • Bachelor's Degree in a healthcare related program with a minimum of one of he following credentials required; Any AHIMA or AAPC coding Credential or equivalent educ/experience

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.

We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.

We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.

Requsition ID: 124370
Company: Providence Jobs
Job Category: Coding
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 4001 SS RC CODING NWR
Address: CA Irvine 3345 Michelson Dr

Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.