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Jackson Health System · 19 hours ago

Coding Compliance Auditor 2, Health Information Management, Full Time, Days

United States

Full-time

Remote

Senior Level

5+ years exp

Jackson Health System is a world-class academic medical center located in Miami, Florida. They are seeking a Coding Compliance Auditor 2 to analyze coded data, ensure coding accuracy, and perform audits on inpatient and outpatient coders while providing education and guidance to the coding staff.

Health CareHospital

Growth Opportunities

Responsibilities

Performs Internal Coding Audits on inpatient and outpatient coders providing feedback and re-training as required

Reviews findings from External Coding Audits for validity of DRG assignment and provide responses if there is a disagreement

Discusses findings and any discrepancies in coding accuracy with external vendor, citing Coding Guidelines and coding Clinics

Perform SMART edit reviews and educate the internal coders on their errors

Review and respond to email requests from the CBO for DRG validation, missing procedure codes, Discharge Status discrepancies and Present on Admission assignments

Provide responses to inquires from insurance companies regarding accuracy in codes used by the facility

Reviews claim denials/audits from insurance companies

Provide education and guidance to the CDI team and the inpatient and outpatient coding staff, reviewing diagnoses and/or procedures that require clarifications

Annual coding updates are reviewed at these sessions, as well as, Coding Guidelines and Coding Clinics

Works with the Rehabilitation Teams from Jackson Main and Jackson North reviewing and advising on concurrent coding worksheets

Works with the CBO and the Revenue Cycle Team providing DRG validation and correcting accounts with missing or incorrect coding

Provides feedback to the coder involved in each case

Entering coding for in-house patients as per CBO request

Works closely with the CDI Team including concurrent DRG validation; provides assistance with assigning DRG's to in-house patients and provides individual guidance and education in applying Coding Guidelines

Works with different services educating them on appropriate documentation to support the severity of the patient's condition. Neonatology Team, Burn Center, etc