Coding Quality Specialist

Trinity Mother Frances Health System Irving , TX 75061

Posted 3 weeks ago

Selected by CHRISTUS Health Coding Leadership to focus coding skills and expertise on internal departmental audits in support of Coding Operations Department, business needs. Coding Auditor Specialist will complete internal, facility level, coding audits and report in a format that provides professional services and feedback to coding staff and any external clients.

Coding Audit Specialist will demonstrate high-quality knowledge and understanding of ICD-10-CM, ICD-10-PCS and/or CPT/HCPCS coding guidelines and practices for acute care reimbursement, while maintaining a 95% audit accuracy rate. The Audit Specialist will have a strong working knowledge of CHRISTUS Health applications in addition to other applicable software, required for auditing.

Coding Audit Specialist will receive work assignments based on departmental needs, including but not limited to PEPPER, new hire and standard pre-bill, performance improvement, corrective action plan, query quality and remediation audits. Coding Audit Specialists will audit for quality in regards to POA assignment, principal and secondary diagnosis code assignment, procedural coding, modifier usage, discharge disposition verification, query opportunities and DRG and APC accuracy.

Coding Audit Specialist will work collaboratively with various CHRITSUS Health Departments, including but not limited to the Regional Coding Managers, HIM, Education Department, Clinical Documentation Specialist to ensure accurate and complete audit results. Coding Audit Specialist will also assist in other areas of the Coding Operations Department, as requested by leadership.

Coding Audit Specialist will report directly to the Specialty Coding Manager, with additional leadership from the Director of Coding Operations and System HIM Director.

  • Facilitate and complete inpatient and outpatient coding audits.

  • Communicates audit results both verbally and in writing in an approved, appropriate format

  • Assist with development and coordination of audit plans, feedback to coding staff and management to include query opportunities, documentation opportunities, accurate code assignment (ICD, CPT, HCPCS), accurate payment groupings (DRG, APC), accurate modifier assignment, accurate POA assignment, accurate discharge disposition assignment, compliance and data management.

  • Assist with chart sample selection for audit and coordinates with Coding Managers.

  • Assist with annual review of charter of targeted chart audits and samples.

  • Work collaboratively with Coding Integrity. Reviews audit results and performs trend analyses to identify patterns and variations in coding practices and case-mix index which require education.

  • Meets or exceeds an audit accuracy rate of 95%.

  • Ensure coding audits are appropriate and effective. Assesses effectiveness through associate evaluations.

  • All other work duties as assigned by Manager.

  • High school diploma or GED.

  • Completion of accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred.

  • Strong written and verbal communication skills.

  • Abel to work independently in a remote setting, with little supervision.

  • Five (5) or more years of Inpatient and/or Outpatient coding experience in an acute care setting.

  • Registered Health Information Administrator (RHIA) (AHIMA)

  • Registered Health Information Technician (RHIT) (AHIMA)

  • Certified Coding Specialist (CCS) (AHIMA)

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Coding Quality Specialist

Trinity Mother Frances Health System