Clinical Coding Auditor - FT - Days - HIMS - Medical Records @ MV

El Camino Health is committed to hiring, retaining and growing the best and brightest professionals who will carry our mission and vision forward. We are proud of our reputation in the community: One built on compassion, innovation, collaboration and delivering high-quality care. Come join the team that makes this happen.

Applicants MUST apply for position(s) by submitting a separate application for each individual job posting number they are interested in being considered for.

FTE

Scheduled Bi-Weekly Hours

Work Shift

Job Description

The Clinical Coding Auditor performs complex reviews/audits of facility (hospital setting) coded data in compliance with Official Coding Guidelines /ICD-10-CM/PCS coding conventions for ancillary outpatient, emergency room, ambulatory /observation records, and inpatient case reviews. Promotes the role of auditor ensuring efficient, high level of coded data quality supports appropriate reimbursement, data collection, and clinical effectiveness outcome studies in meeting regulatory accreditation requirements for state and federal reporting in compliance with the Department of Health Care Access and Information (HCAI) and other external reporting purposes. The auditor acts as liaison and works in conjunction with the Revenue Cycle teams in ensuring diagnosis and procedural coding meets the national standards through collaborative discussion/reviews with third-party claims editor applications. Provides coder specific educational topics and presentations based on claim denials and trends. Compiles reporting and reviews of Patient Safety Indicators/Hospital Acquired Conditions by tracking/monitoring in reporting to Clinical Documentation Integrity (CD) and quality teams. Assists with on-boarding of new staff and trains existing team members with new service line coverage. Provides general coding coverage when required and other duties assigned in work from home position.

Qualifications

1. Completion of college level coursework in ICD-10-CM and CPT coding, anatomy and physiology, and medical terminology.

2. Minimum of four years' experience in auditing claim denial reviews in acute care hospital setting.

3. Three (3) to five (5) years' experience in coding and demonstrating knowledge in the principals and practices of ICD-10-CM/PCS and CPT conventions for ancillary outpatient, emergency room, outpatient surgical, observation records, and inpatient records.

4. Technical aptitude for resolving basic PC hardware and software application problems and ability to perform basic troubleshooting.

5. Strong communication skills with technical knowledge with conference meetings.

6. Proficient with Excel, Word, and Outlook.

7. Demonstrated ability to work productively, accurately, and independently with minimal supervision or assistance from coworkers.

8. Comprehensive analytical and problem solving skills in compiling statistical data.

9. Comprehensive mastery of APC assignment methodology with emphasis in NCCI edits.

10. Ability to interact well with all levels of employees and physicians throughout the organization

License/Certification/Registration Requirements

• AHIMA Certified Coding Specialist (CCS) credential required

• Registered Health Information Technician (RHIT) preferred

Ages of Patients Served

This position will serve all age groups.

Salary Range:

The Physical Requirements and Working Conditions of this job are available. El Camino Health will provide reasonable accommodations to qualified individuals with a disability if that will allow them to perform the essential functions of a job unless doing so creates an undue hardship for the hospital, or causes a direct threat to these individuals or others in the workplace which cannot be eliminated by reasonable accommodation.

An Equal Opportunity Employer:
El Camino Health seeks and values a diverse workforce. The organization is an equal opportunity employer and makes employment decisions on the basis of qualifications and competencies. El Camino Health prohibits discrimination in employment based on race, ancestry, national origin, color, sex, sexual orientation, gender identity, religion, disability, marital status, age, medical condition or any other status protected by law. In addition to state and federal law, El Camino Health also follows all applicable fair and equitable employment policies from the County of Santa Clara.