Auditor

Company: Waterbury Hospital
Location: Waterbury
Posted on: May 27, 2023

Job Description:

Position Summary:The Auditor will perform coding and charge capture quality audits of outpatient/ED records to assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines, other Federal/State regulatory agencies, and PMH policies for all PMH hospitals. This position will provide ongoing feedback and analysis of audit findings to educate staff in areas of opportunity. The Auditor will also serve as a liaison and will be responsible for providing assistance with coding inquiries from internal organizational stakeholders.Essential Job Functions:The essential functions below are not intended to be an exhaustive list of all duties that may be assigned to this position, nor does it restrict the duties which may be assigned to this position if such duties reasonably relate to the position.% EffortPerform audits to ensure coding & charging accuracy, quality, and compliance audits to ensure appropriateness and accurate code/charging assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines, other Federal/State regulatory agencies, and PMH policies for all PMH hospitals.30%Maintains audit documentation, including, identified issues, individuals involved, corrective actions taken, and improvements implemented. Monitor, analyze and stay current with innovative tools and trends in coding/coding auditing. 20%Provide education to coders based on audit findings, utilize expertise to research and respond to challenging coding/charging questions, develop, and provide coding/charging education and evaluate audit results to recommend corrective actions.20%Articulate audit findings appropriate for audience. Prepare written audit reports as needed summarizing audit findings and any corrective action necessary to mitigate risk.20%Work with HIM coding management in developing education and training for coders, clinical departments, and Revenue Integrity/Revenue Cycle staff.10%Total Effort:100%Core Organizational Values:We are a coordinated network of hospitals, affiliated medical groups and ancillary health care services working for the benefit of every person who relies on and trusts us for care. Our comprehensive networks aim to provide coordinated, personalized care. Through our affiliated networks, we strive to provide a healing environment and quality care by demonstrating the following organizational core values:TEAMWORK: We recognize trusting relationships are key to achieving success.INTEGRITY: We are down-to-earth, honest and approachable.ACCOUNTABILITY: We honor our commitments and focus on "how it can be done".INNOVATION: We embrace change and continually seek new ways to improve.COMPASSION: We understand and reflect the diverse communities we serve.EXCELLENCE: We are committed to the highest quality and safety standards.Required Qualifications:Associate degree or higher in healthcare related concentration such as Health Information Management or Health Information Technology or equivalent experienceCPC, CCS, CPMA or other coding credentialFive (5) years progressive coding experience in a complex acute care setting, with at least three (3) years in coding auditProficient in application of acute hospital coding guidelines, audit processes in compliance with Federal and State regulatory agencies, and industry standard best practicesAbility to accurately assign ICD-10-CM/PCS and CPT-4 codes to complex outpatient encounters such as observation, outpatient surgery and interventional radiology using ICD-10-CM/PCS and CPT-4 codes Work with HIM coding management in developing education and training for coders, clinical department and/or physicians for documentation improvementAbility to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding integrityAbility to maintain the national standards for coding accuracy and internal standards for productivity; Computer skills; Communication skills; Coding and auditing skillsStrong critical thinking skills and ability to multitask and maintain a work pace appropriate to workloadComfortable and very experienced in leading remote education and training sessions to a group or individuals while using WebEx and other similar applicationsMust maintain active coding credential by obtaining qualifying CEUs as neededComputer literacy and proficiencyMust demonstrate customer service skills appropriate to the jobPreferred Qualifications:Experience with computer assisted coding (CAC) productsExperience with Cerner workflowsLocation: Waterbury Hospital AdministrationSchedule: Full Time, Days, 40 hrs Days

Keywords: Waterbury Hospital, Waterbury , Auditor, Accounting, Auditing , Waterbury, Connecticut