HIM Coding Review Manager/Coder Trainer Auditor (Cta)

Cross Ocean Technologies San Diego , CA 92101

Posted 1 week ago

looking for an outpatient surgery & ED auditor that will be on site initially 5 days a week and then it will wean down to 3 days a week onsite and 2 days remote. 40 hours a week for a year

Top 3-5
Daily

Responsibilities:

  1. Coder education
  2. Coding Audit
  3. Nosology

Top 3-5 Required Skills:

  1. CCS Certified
  2. AHIMA approved ICD10 CM and PCS trainer
  3. Minimum four (4) years combined experience assigning and auditing AMA CPT and CMS HCPCS codes, as well as ICD-10 CM/PCS and ICD-9-CM diagnoses and procedure codes in an acute care setting required

Desired Skills:

  1. Familiarity with 3M 360 Encompass and EPIC modules Soft

    Skills:
  2. Strong communication skills
  3. Familiar with and able to work in a labor and management partnership

As a CTA, candidates are actively involved in mentoring & training all functions & services related to hospital medical coding, medical documentation, & physician queries, abstracting & data collection. Must possess a proficient understanding of the Inpatient and Outpatient Prospective Payment Systems (IPPS/OPPS), Medical Severity Diagnosis-Related Groups (MS-DRG), National Correct Coding Initiative Edits (NCCI), ICD-9-CM Official Guidelines for Coding and Reporting, and Coding Clinic. Must be able to work in a Labor-Management Partnership environment. Works with Coding Supervisors & HIM Director to develop, implement, evaluate & improve coders participating in the HIM Department On-the-Job Training (OJT) Program.


Both the Coding Review Manager and the CTA will have the following duties:
Coordinates monitors and audits all lines of hospital business for coding, to include: all outpatient, inpatient, HOV, ED and Ambulatory surgery cases. Monitors the accuracy and quality of coding assignments, Present on Admission (POA) indicators and conducts internal coding audits. Responsible for being the regional coding contact person for the HIM department to work with Clinical Documentation Specialists to support education and coding requirements. Develops reports of audit results to Regional and facility staff and Senior Management. Helps set the direction for coding and compliance education and focused projects related to the KPHC (KP Health Connect-EHR). Provide oversight and training for Coding Compliance Software to the coding staff. Run audit selection lists and reports as well as providing education, feedback and guidance based upon data mining activities and processes.
May provide insight into planning, directing and monitoring of Charge Capture Initiatives for Facility and Professional Charges as well as in-patient medical records(for Coding Review Manager) including: CMS, Fiscal Intermediary, Commercial and Self-Funded billing guidelines retrieval, assembly, delivery, abstracting/analyzing, coding, completion, transcriptions, release of information, and vital statistics registration. May provide (limited) oversight of the accuracy of MIRCal data for OSHPD reporting. Collaborates with the HIM Director/Manager relating to coding accuracy and coding functions within the department to assure timely and accurate completion of work that is consistent with regulatory agency requirements.
Prepares statistical and or annual coding accuracy reports as requested by state or federal agencies or any other regulatory agency under the direction of their Manager. Ensures compliance with federal, state and local regulations.
May assist in regional and facility budgets as requested and identifies and recommends opportunities to decrease costs and improve service. Functions as a liaison for other departments regarding coding questions/issues. Implements changes resulting from internal or external audits which impact collection and reporting of medical records. Participates in Regional HIM staff meeting and process improvement initiatives.
NOTE: Travel between Medical Center facilities is required, in addition to the Regional Offices.
Consistently supports compliance and the Principles of Responsibility by maintaining confidentiality, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable Federal and State laws and regulations, accreditation and licensure requirements, and policies and procedures.
In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the Service Quality Credo, the Mission as well as specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our members, and to purchasers, contracted providers and vendors.

Requirements



Qualifications:
Minimum of 4+ years of Acute Care: Inpatient, Outpatient, MS-DRG, HCC and APC coding required. Coding Review Manager also requires 4+ years supervisory experience in a Medical Records department In-depth understanding of all state/federal regulations and CMRI, NCQA, JCAHO, and CMS. Demonstrated strong interpersonal communication skills. Ability to develop and provide high quality in-service and seminar of coding and coding related topics. Working knowledge of State/Federal, CMRI, NCQA, JCAHO, and CMS Regulations.
Preferred Qualifications:
Certified coding Specialist (CCS). May also possess Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) or RHIA/RHIT credentials (for Coding Review Manager) Electronic Health Record experience preferred.

Benefits

Cross Ocean Technologies, Inc. is an Equal Opportunity Employer that actively pursues and hires a diverse workforce. All qualified applicants will receive consideration for employment without regard to age, ancestry, color, disability (mental or physical), gender identity or expression, genetic information, marital status, medical condition, military veteran status, national origin, political affiliation, pregnancy, race, religion or creed, sex, sexual orientation, or any other factor that is not related to the job.

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HIM Coding Review Manager/Coder Trainer Auditor (Cta)

Cross Ocean Technologies