Manager Coding Audit, Remote

Job Requirements

General Summary

The Manager of Coding Audits will organize audits at all facilities aimed at confirming compliance with health system guidelines as well as with all regulatory agencies (OIG, HSCRC, CMS, NCCI, and OCG). The Manger of Coding Audits will be responsible for the overall auditing of all coders, auditors, and CDI staff to ensure success in coding compliance and documentation improvement.

The Manager of Coding Audits will collaborate with the Coding Manager and/or Manager of Training on the recommendation of Performance Improvement Plans (PIP).

The Manager of Coding Audits will work with CDI at all facilities to ensure compliance with all guidelines as well as identify opportunities in documentation improvement.

The Manager of Coding Audits will ensure all auditors have completed departmental orientation prior to performing any auditing functions.

The Manager of Coding Audits will participate in coding Roundtable (CRT) discussions.

II. Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Manages, plans, organizes, monitors, and evaluates all auditing functions to ensure effective and efficient operations and compliance with established standards, rules, and regulations.

a. Auditing process for ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, observation, and other OP visits.

b. Auditing process for inpatient services to include but not limited to trauma, transplant, and critical care to ensure accurate assignment of ICD-10-CM and ICD-10-PCS codes, as well as APR-DRG, SOI, ROM, and POA assignment.

c. Focus audits to include MHAC, PPC, PSI, PQI, and mortality to identify trends in documentation issues, coding and query opportunities which affects overall reimbursement.

Assists with development and implementation of the compliance audit plan to ensure adherence to compliant coding practices to address compliance issues and concerns related to all federal and state regulatory requirements. Manage all external audits to ensure compliance with coding guidelines and facility policies.

2. Serves as communicator between Clinical Documentation Specialists and Coding.

Track and report coding quality accuracy for coding and CDI staff. Monitor productivity rate for coding auditors. Perform quality assessments on auditors to ensure compliance in coding recommendations and coding accuracy. Creates and monitors inpatient case-mix reports, denials, top APRs to identify patterns, trends and variances in all assigned APR-DRGs.

3. Updates Sr. Manager of Coding Quality and Education and other key stakeholders on the status and activities pertaining to coding compliance. Prepare reports and monitoring documents that identify areas for improvement, and effectively communicate findings and recommendations to Sr. Manager of Coding Quality and Education. Conducts regularly scheduled meetings with auditing staff to communicate issues regarding compliance with established procedures and overall work unit effectiveness. Provide feedback to Manager of Training Education regarding patterns of coding errors needing educational intervention.

4. Under the supervision of the Sr. Manager of Coding Quality, hire, orient, and train new trainers, complete performance evaluations, and handle corrective actions. Provide an open and goal oriented work environment with established clear and concise work procedures and productivity standards. Coaches and guides team to operational excellence and a culture of accountability

5. Complies with AHIMA and ACDIS standards of ethical coding, querying, and coding compliance guidelines. Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies. Attends seminars and in-services as required to remain current on coding issues. Attend departmental and interdepartmental meetings and actively participate in committees as assigned.

Work Experience
Education and Experience

1. Associates degree Health Information Technology or related field or 7 years exp. Bachelor’s degree in related field preferred.

2. 5 years’ experience with coding inpatient outpatient hospital medical records.

3. 3 years supervisory experience/management experience required in the coding field, supervising professional/supervisory staff. 5 years auditing experience.

4. Managing Multi-facility departments preferred.

5. One of the following: Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), AHIMA Approved ICD10CM/PCS Trainer, Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP).

6. Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) preferred.

Knowledge, Skills and Abilities

Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.

Pay Range: $42.64-$64.00

Other Compensation (if applicable):

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