Driscoll Children's Hospital · 1 day ago
Certified IP Coding Auditor
Texas, United States
Full-time
Onsite
Mid, Senior Level
3+ years expDriscoll Children's Hospital is committed to compassion and innovation in healthcare. They are seeking a Certified IP Coding Auditor who will lead the Clinical Documentation team, ensuring accurate coding and documentation for pediatric patients while collaborating with various healthcare professionals to enhance clinical documentation practices.
Child CareChildrenHealth CareMedical
Responsibilities
Completes initial reviews/concurrent coding within 1 -2 working days in order to promptly identify potential documentation improvement opportunities
Conducts follow-up reviews/concurrent coding of patients every 2-3 working days to support and assign a working or final APR- DRG. Queries physicians regarding missing, unclear, or conflicting health record documentation
Educates physicians and key healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the health record
Collaborates with CDI Physician Champion, case managers, nursing staff, and other ancillary staff regarding interaction with physicians on documentation and to resolve physician queries prior to patient discharge
Participates in the analysis and trending of statistical data for specified patient populations to identify documentation improvement opportunities
Assists with preparation and presentation of clinical documentation monitoring/trending reports for review
Partners with the coding professionals when necessary to ensure accuracy of diagnostic and procedural data and completeness of supporting documentation to assign ICD-10-CM/PCS diagnosis and procedure codes to determine an accurate working and final APR-DRG, severity of illness, and/or risk of mortality
Ensure accuracy and optimization of quality initiatives such as Potentially Preventable Events, ICD-10, Data Governance, and future initiatives by performing concurrent/retrospective coding and CDI reviews and facilitating workflow
Reviews all mortality and PPE accts notified by CQA for coding documentation opportunities and communicates with QA dept as necessary
Assists other CDI Specialists with daily software, coding, workflow, and CDI questions as able
Communicates with CDI Champion as needed to discuss no response queries or obtain objective clinical perspective
Assist with retrospective coding review needed for statistical validation for external reporting entities such as STS, THCIC, and CHA
Ensure accuracy and optimization of quality initiatives such as Potentially Preventable Events, ICD-10, Data Governance, and future initiatives by performing reviews and facilitating workflow
Demonstrates a consistent level of performance and strives to maintain a steady level of productivity in all duties assigned
Assist HIM management with software implementation/testing/updates/support
Maintains utmost level of confidentiality at all times
Adheres to hospital policies and procedures
Demonstrates business practices and personal actions that are ethical and adhere to compliance and integrity guidelines
A teamwork approach, organization, problem-solving skills and flexibility are required
Demonstrates a thorough knowledge of computer applications and the ability to do research
Excellent interpersonal and communication skills required, professionalism is essential
Proficiency in the use of Microsoft applications (e.g. Word, Excel, PowerPoint), Epic, and 3M 360
Qualification
Required
RHIA, RHIT, or CCS with a minimum of three years hospital-based inpatient coding experience, or are clinical candidates credentialed as RN, LVN or BSN with a strong clinical background and a minimum of three years clinical experience in Pediatrics, Med-Surg, ICU, or Surgery
CCS coding certification required or CCS eligible- to be achieved within 1 year of employment
CDIP, or CCDS, eligible- to be achieved within 1 year of employment
High level of clinical proficiency necessary for leadership of the Clinical Documentation team of licensed nurses and certified coders
Knowledge of official medical coding guidelines, CMS, and private payer regulations related to the Inpatient Prospective Payment System
Ability to analyze and interpret medical record documentation and formulate appropriate physician queries
Ability to benchmark and assist in analyzing clinical documentation program performance
Sufficient knowledge of clinical documentation, coding reporting requirements, APR-DRG assignment, and clinical conditions or procedures impacting severity of illness, risk of mortality, and/or data quality
Ability to facilitate complete and accurate documentation and coding of inpatient medical records on a concurrent and retrospective basis
Ability to collaborate with interdisciplinary teams including physicians, nurse practitioners, PA's, Quality, Case Management, Risk Management, Health Information Management/Coding, Decision Support, product vendors, and other members of the health care team
Knowledge and leadership of the day-to-day processes of the Clinical Documentation team including workflow and training needs to meet the expected requirements
Ability to assist management with providing ongoing Clinical Documentation education for current and new staff, including new Clinical Documentation Specialists, physicians, nurses and allied health professionals
Ability to track and trend program performance
Ability to complete initial reviews/concurrent coding within 1 -2 working days
Ability to conduct follow-up reviews/concurrent coding of patients every 2-3 working days
Ability to educate physicians and key healthcare providers regarding clinical documentation improvement
Ability to participate in the analysis and trending of statistical data for specified patient populations
Ability to assist with preparation and presentation of clinical documentation monitoring/trending reports
Ability to partner with coding professionals to ensure accuracy of diagnostic and procedural data
Ability to ensure accuracy and optimization of quality initiatives such as Potentially Preventable Events, ICD-10, Data Governance, and future initiatives
Ability to review all mortality and PPE accounts notified by CQA for coding documentation opportunities
Ability to assist other CDI Specialists with daily software, coding, workflow, and CDI questions
Ability to communicate with CDI Champion as needed
Ability to assist with retrospective coding review needed for statistical validation for external reporting entities
Ability to demonstrate a consistent level of performance and maintain a steady level of productivity
Ability to assist HIM management with software implementation/testing/updates/support
Ability to maintain utmost level of confidentiality at all times
Ability to adhere to hospital policies and procedures
Ability to demonstrate business practices and personal actions that are ethical and adhere to compliance and integrity guidelines
Ability to work in a teamwork approach, organization, problem-solving skills and flexibility
Ability to demonstrate a thorough knowledge of computer applications and the ability to do research
Excellent interpersonal and communication skills required
Proficiency in the use of Microsoft applications (e.g. Word, Excel, PowerPoint), Epic, and 3M 360
Preferred
RN, LVN or BSN preferred
Company
Driscoll Children's Hospital
We provide the absolute best pediatric care in South Texas, where care and community come together. Together, we heal.
1001-5000 employees
H1B Sponsorship
Driscoll Children's Hospital has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (12)
2023 (6)
2022 (4)
2021 (10)
2020 (8)
Funding
Current Stage
Late StageTotal Funding
$0.53MKey Investors
Toyota Motor
2024-09-26Grant· $0.53M
Leadership Team
Mary Peterson
Executive Vice President and COO
Recent News
GlobeNewswire News Room
2025-07-10
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2025-03-06
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