Coding Education Auditor-Outpatient (Remote)
Requisition #: 183267
Location: Johns Hopkins Hospital/Johns Hopkins Health System, Baltimore, MD 21201
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: March 22, 2019
Johns Hopkins Health System employs more than 20,000 people annually. When joining the Johns Hopkins Health System, you became part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. Great careers continually advance here.
Under the direction of the Coordinator, Outpatient Education & Audits, the Coding Education Auditor, Outpatient will be responsible for assisting with developing all education and coding quality improvement initiatives for the Outpatient Coding Division at JHHS. The Coding Education Auditor, Outpatient is responsible for analyzing, reviewing and resolving coding and documentation issues that are related to reimbursement, compliance and revenue enhancement. The Auditor will perform focused second level coding quality reviews, as needed, to support improving coding quality for each outpatient Coding Specialist. The Auditor will document relevant trends of inaccurate coding and areas that are high risk for compliance issues to the Coordinator. The Auditor is responsible for offering recommendations for improvement to maintain a minimum of 95% coding quality across the JHHS enterprise. The Auditor will utilize the nThrive DNA learning management system to assist with coding education and skill development. This individual will assist with conducting investigation and research of existing policies, guidelines and precedent cases in publications such as Federal Register, AHA Coding Clinic, and AHIMA Journal to support internal policy development. Additional research will include AHRQ, RAC SOW, OIG Coding Compliance Plan and Correct Coding Initiative Guidelines to determine JHHS internal focused audits plan for the fiscal year. The Auditor will assist with special projects assigned by the Coordinator, Outpatient Education & Audits.
Full Time, Day Shift
Pay Grade: NK
Minimum Associate’s Degree in HIM or health-care related field required. Bachelor’s degree preferred.
Required Licensure Certification:
Requires Certified Coding Specialist (CCS) certification. RHIT or RHIA credentials preferred. Candidate will be required to pass AHIMA approved Outpatient Coding Specialist II assessment prior to hire.
Requires minimum of 3 years outpatient coding experience required. 1 year of auditing experience preferred.
Knowledge and Skills:
Requires excellent and comprehensive knowledge of Anatomy, Physiology, as defined by the Medical Diagnostic Categories and all body systems. Strong background knowledge of disease process and Pharmacology. Knowledge of Outpatient coding quality programs and payer models, including but not limited to: CMS’s Outpatient Prospective Payment System and APC reimbursement, Maryland’s HSCRC outpatient reimbursement, all applicable OCE edits which includes NCCI and NCD/LCD edits and the accuracy of coded data impacting reimbursement and external quality databases. Must be conversant in, with an advanced knowledge of ICD-10 CM, CPT, APCs and APGs. Must possess demonstrable coding and auditing expertise. Must be proficient with Microsoft Word, Excel, and Power Point. Requires in-depth knowledge of clinical coding processing and documentation standards, guidelines, policies and procedures. Must be conversant in clinical documentation improvement. High level of proficiency in adult education and training. Requires a thorough understanding of Hospital bylaws and Joint Commission standards related to departmental activities. Requires knowledge of clinical pertinence requirements and proficiency in abstraction and data entry into the entire database systems used for medical record coding. Must be able to read and interpret electronic and manual documentation generated by healthcare professionals. Requires understanding of HSCRC and CMI impact on hospital reimbursement.
Requires analytical ability to allow for interpretation of clinical data in all clinical specialties to determine appropriate diagnoses supported by clinically pertinent data, ICD-10 CM and CPT coding classification systems. Requires excellent written, oral communication and interpersonal skills. Ability to effectively communicate with all HIM Administrative staff, Coding Professionals and Hospital practitioners is essential. Requires the ability to provide constructive feedback for the development of coding staff. Requires the ability to develop and conduct in-service training relative to coding for groups of coding staffs. Must demonstrate knowledge of and experience with coding and auditing of inpatient and outpatient medical records. Ability and willingness to travel to Maryland and DC area based JHHS hospitals. Ability to work independently.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
Johns Hopkins Medicine.