Coding Quality Auditor ? Surgery (Fully Remote) in USA
Posted 2025-03-14Coding Quality Auditor - Surgery (Fully Remote) - Cleveland Clinic - USA - work from home job
Company: Cleveland Clinic
Job description: At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.
We all have the power to help, heal and change lives ? beginning with our own. That?s the power of the Cleveland Clinic Health System team, and The Power of Every One.
Job Title Coding Quality Auditor - Surgery (Fully Remote)
Location Cleveland
Facility Remote Location
Department HIM Coding-Finance
Job Code T98559
Shift Days
Schedule 8:00am-4:30am
Job Summary Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.
As a Coding Quality Auditor, you will review coded claims to provide feedback and share trends with coders, providers and leadership to support improvements throughout the organization. Going beyond traditional coding review, our process includes ongoing assessment of our risks, feedback and continuous improvements.
The ideal future caregiver is someone who:
? Has coding credentials and certification (RHIA, RHIT, CCS, CCS-P, CPC).
? Has a desire to learn and grow in a dynamic and challenging environment.
? Enjoys working as part of a team.
? Takes pride in their work and wants to make a difference.
At Cleveland Clinic, we know what matters most. That's why we treat our caregivers as if they are our own family, and we are always creating ways to be there for you. Here, you'll find that we offer: resources to learn and grow, a fulfilling career for everyone, and comprehensive benefits that invest in your health, your physical and mental well-being and your future. When you join Cleveland Clinic, you'll be part of a supportive caregiver family that will be united in shared values and purpose to fulfill our promise of being the best place to receive care and the best place to work in healthcare.
Job Details
Responsibilities: ? Responsible for auditing Electronic Medical Records and/or, procedural cases and/or surgical cases, pre-bill coding, DRG and APC Quality Audits, case mix analysis, and compliance software reviews on highly complex cases. ? Responsible for providing feedback on the application of coding guidelines, practices, and proper documentation techniques, data quality improvements, and revenue enhancements. ? Performs retrospective and concurrent audits based on coding guidelines to ensure coding accuracy and proper reporting. ? Prepares and presents reports for pre-bill and retrospective coding audits directly to audited Providers and coders. ? Demonstrates the ability to analyze coded data to identify areas of risk and provide suggestions for documentation improvement. ? Assists in the development of programs and procedures to support improvement of coding accuracy rate. ? Interacts with Providers, and coding staff to resolve documentation or coding issues. ? Responds to coding questions from assigned coders /providers and provides official coding references and guidelines. ? Provides routine interaction with Providers, and coding staff to assist with or resolve issues relating to medical record documentation and coding. ? Assists with the facilitation of scheduled external audits. ? Assists with the analysis of case mix reports and other statistical reports. ? Maintains current knowledge of coding principles and guidelines as coding conventions are updated; monitors and analyzes current industry trends and issues for potential organizational impact. ? Reports any compliance and/or risk issues to the compliance department. Provides suggestions on process improvement. ? Makes recommendations for coding policy/guideline changes. ? Other duties as assigned.
Education:
? High School Diploma required.
? Associate?s Degree preferred.
? A Bachelor?s Degree preferred.
? Specific training related to CPT procedural coding and ICD-10 diagnostic coding through continuing education programs/seminars and/or community college preferred.
Certifications:
? A minimum of one of the following certifications is required and must be maintained: the American Health Information Management Association (AHIMA) Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) , Certified Coding Specialist-Physician (CCS-P), or the American Academy of Professional Coders (AAPC) Certified Inpatient Coder (CIC) or Certified Professional Coder (CPC).
Complexity of Work:
Coding assessment relevant to the work may be required. * Ability to present information to various audiences.
? Proficiency in Microsoft Office Applications (e.g., Word, Excel).
? In depth knowledge of ICD-10-CM/PCS coding principles, CPT coding principles, DRG assignment, APC assignment, and modifier assignment.
? Working knowledge of human anatomy and physiology, disease processes.
? Demonstrated knowledge of medical terminology.
? Knowledge of auditing concepts and principles.
? Excellent verbal and written communications.
Work Experience:
? A minimum of 5 years professional coding experience required.
? A minimum of 2 years of progressive on-the-job experience as a coding quality auditor in a health care environment and/or medical office setting preferred.
? An Associate?s Degree may offset up to 1 years of required experience.
? A Bachelor?s Degree may offset up to 2 years of required experience.
Physical Requirements: ? Ability to perform work in a stationary position for extended periods. ? Ability to travel throughout the hospital system. ? Ability to work with physical records, such as retrieving and filing them. ? Ability to operate a computer and other office equipment. ? Ability to communicate and exchange accurate information. ? In some locations, ability to move up to 25 lbs.
Personal Protective Equipment:
? Follows standard precautions using personal protective equipment as required.
The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All offers of employment are follwed by testing for controlled substances and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.
Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.
Please review the .
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities
Coding Quality Auditor - Surgery (Fully Remote) - Cleveland Clinic - USA - work from home job
Expected salary:
Location: USA
Coding Quality Auditor - Surgery (Fully Remote) - Cleveland Clinic - USA - work from home job
Job date: Sat, 05 Aug 2023 04:10:51 GMT
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Coding Quality Auditor - Surgery (Fully Remote) - Cleveland Clinic - USA - work from home job
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