Facility HIMS Coding Auditor

Department Name: Coding-Acute Care Compl & Educ Work Shift: Day Job Category: Revenue Cycle Estimated Pay Range: $32.09 - $53.48 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care. Our HIMS Auditors play a critical role at Banner Health. Join our team of forward-looking Facility Coding Auditors who support our Inpatient Facility Coding teams. This is an Auditing position, not a day-to-day coding production role but does require coding proficiency and recent Hospital Facility Coding experience. In this role you will work alongside the Quality, CDI and Education teams to be the subject matter experts for our teams. Location: REMOTE, Banner provides equipment Schedule: Full time, Exempt; Flexible scheduling after training completed Ideal Candidates: • 3 years recent experience in Facility Inpatient coding (trauma, academic or high acuity facilities is preferred) and/or auditing and education experience (clearly reflected in your attached resume); • Bachelors Degree or equivalent experience; • A Coding Assessment will be given after a successful interview to be completed within 48 hours. You will be fully supported in during initial training by both the Banner Coding Education team and your hiring manager, with continued support throughout your career here! • Don't quite meet the above requirements? Check out some of our other Coder positions! This is a fully remote position and available if you live in the following states only: AK, AL, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MI, MN, MO, MS, NC, NH, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV & WY. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. Position Summary This position is responsible for audit and analysis of clinical documentation to support coding accuracy and reimbursement to identify possible opportunities for improvement. Assess adherence to Coding Guidelines, conventions and compliance with Banner Policies and Procedures. In addition to collecting/analyzing/distributing data and information, works collaboratively with Coding Leadership and key stakeholders to ensure appropriate chart review. Performs audits for internal, as well as external customers, to provide feedback on coding and documentation opportunities. Collaborates with Education Team to develop staff education. Core Functions • Performs routine, focused and specialized audits on charts to ensure compliance with Coding Guidelines and alignment with clinical documentation. Provides feedback to staff on appropriateness and accuracy of coding and provides education, as needed, to correct any identified opportunities. Tracks individual and group staff performance to provide quality metrics to Leadership. • Works with Banner stakeholders to evaluate and identity documentation opportunities. Provide feedback on audit results to include recommendations for coding and documentation. Establish, implement and maintain formalized review and audit processes. • Work with external key stakeholders including but not limited to safety net vendors, government auditors, and revenue cycle vendor partners to evaluate audit findings and provide feedback utilizing authoritative references and Banner policies. Track results to collaborate on needed education or process improvement. • Develop and maintain audit data used to monitor staff quality metrics for use in reporting, process improvement, education development, and quality improvement. • Collaborates on the development, implementation, and maintenance of billing and audit system rules and collaborates on needed education. Identifies issues concurrently and communicates to appropriate leadership to facilitate timely action on education and/or edit creation. • Develop audit-driven data to trend patterns and individual quality results by addressing items to include but not limited to: abstracting, principal diagnosis selection, principal procedure selection, missed query opportunities, etc. Uses data to participate in improvement of processes and programs through collaboration with leadership and education teams. • This position is responsible for projects across multiple departments system-wide and requires interaction at all levels of staff and management. Requires work in the context of multiple commitments, priorities and conflicts. • Functions in a fast-paced healthcare environment with a wide variety of healthcare programs, activities, and settings. This position is accountable for all resources within the areas of operational responsibility to ensure standards are exceeded for customer service, financial management and regulatory compliance. Internal customers include employees at all levels within the organization, including system leadership. External customers include vendors, providers and government entities. • Works under limited supervision using specialized expertise in the subject matter. Works within a set of defined rules. Ability to address related and complex matters independently with regard to interpretation of coding guidelines, NCCI edits, and LCDs (Local Coverage Determinations) prior to referral to leader. Provides direction and feedback to all levels of coding staff and reinforces quality/education targets to assist with meeting quality metrics. Minimum Qualifications Must possess a current knowledge of business and/or healthcare as normally obtained through the completion of a bachelor’s degree in business administration, healthcare administration or related field, or experience equivalent to same. Demonstrated proficiency in hospital coding as normally obtained through seven years of current and progressively responsible coding experience required. Requires a Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Specialist-Physician (CCS-P) or Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA), or other qualified coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Must possess a thorough knowledge of ICD/DRG coding and/or CPT coding principles, as recommended by the American Health Information Management Association Coding Competencies. Requires an in-depth knowledge of medical terminology, anatomy, and physiology, plus a thorough understanding of the content of the clinical record and extensive knowledge of all coding conventions and reimbursement guidelines across service lines, LCD/NCDs and MAC/FIs. Extensive critical and analytical thinking skills required. Ability to organize workload to meet deadlines and maintain confidentiality. Excellent written and oral communication skills are required, as well as effective human relations skills for building and maintaining a working relationship with all leaves of staff, physicians, and senior leadership stakeholders. Able to identify areas of risk that require leader escalation. Must be able to function as part of a team, using effective interpersonal and instructional skills. Must have the ability to conduct educational needs analysis and to teach effectively to a wide range of comprehension levels. Must be proficient in the use of common office and presentation software and have an advanced knowledge and experience with computer healthcare applications and hardware. Must be able to work effectively and efficiently in a remote setting. Preferred Qualifications Prior audit experience, experience creating spreadsheets, pivot tables and normalizing data preferred. Previous Experience In Large, Multi-system Healthcare Organization Preferred Additional related education and/or experience preferred. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy Apply tot his job