Coding Audit Training Specialist

Job Description:

The HIM Coding Audit Training Analyst Coordinator provides advanced training to hospital coding staff, compliance, CDI, physicians, and clinical staff. This Coordinator serves as a subject matter expert for all ICD-10 CM/PCS and CPT coding practices, conventions, regulatory, and reimbursement guidelines for the system. They audit and monitor all areas of hospital coding. The coordinator works with providers and clinical staff to make critical coding decisions based on incomplete, and ambiguous record documentation. They assist the coders in converting patient diagnoses and procedures documented by the providers in the EHR (Electronic Health Record) to ICD10/PCS and CPT codes at an advanced level of complexity.

Essential Functions

• Provides advanced training to acute coders at all levels, providers, clinical staff, compliance and the CDI team.

• Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding review, audit findings, and appeal strategies.

• Develops and implements training plans for all internal stakeholders including coders at all levels, providers, clinical staff, compliance and the CDI team.

• Audits clinical documentation and coding for complex internal and external coding questions

• Ensures that coded data accurately reflects the severity of illness, risk of mortality, and quality of care

• Performs audits including DRG (Diagnosis Related Groups), ICD-10 CM/PCS (Procedure Classification System), CPT, and PSI (Patient Safety Indicators)

• Analyzes data and collaborates with applicable stakeholders to identify aberrant coding patterns and trends.

• Participates in hospital quality improvement initiatives to assure accurate reimbursement

• Participates in integrated testing of Epic, Solventum, and other software

Skills

• ICD-10 CM/PCS and CPT

• Electronic health record

• Anatomy, physiology & pathophysiology

• Training

• Detail oriented

• Coding software

• Interpersonal skills

• Auditing

• Computer skills

• Analytical skills

Physical Requirements:

Qualifications

Required

• AHIMA CCS coding certification

• Demonstrates expert level ability to understand and compliantly apply complex coding and billing requirements.

• Demonstrates strong knowledge and understanding of medical terminology, medical acronyms, pharmacology, anatomy and physiology and ICD-10-CM/PCS, DRG, and APR-DRG classification systems.

• Ability to complete and pass internal Lead coding exam.

• Demonstrates proficiency in using coding software, electronic health records, and other health information systems.

• Demonstrates excellent communication, interpersonal, and analytical skills

• Demonstrated acute care facility coding experience which includes both ICD-10-CM/PCS and CPT coding with multidisciplinary service lines

Preferred

• Bachelor's degree in health information management (RHIT), health informatics, or related field from an accredited institution. Education will be verified.

• Three (3) years of experience in an HIM Coding role.

• Demonstrated experience creating training programs and knowledge of adult learning styles.

• Demonstrated proficiency with EPIC EHR and 3M 360 CAC (Computer Assisted Coding), using 3M automation tools .

Physical Requirements

• Ongoing need for caregiver to see and read information, labels, monitors, identify equipment and supplies, and be able to assess customer needs.

• Frequent interactions with customers that require caregiver to communicate as well as understand spoken information, alarms, needs, and issues quickly and accurately.

• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer, phone, and cable set-up and use.

• Expected to lift and utilize full range of movement to transport, pull, and push equipment. Will also work on hands and knees and bend to set-up, troubleshoot, lift, and carry supplies and equipment. Typically includes items of varying weights, up to and including heavy items.

• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

Location:

Peaks Regional Office

Work City:

Broomfield

Work State:

Colorado

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$33.75 - $53.16

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here ( .

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

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All positions subject to close without notice.