Coding Quality Reviewer

The Coding Quality Reviewer supports coding compliance and accuracy through analyzing clinical documentation and performing concurrent and/or retrospective IP or OP audits as part of training and education. Works with multiple internal HIM and external Revenue Cycle partners at various levels of the organization to support coding, education, and training needs.

Additional Information
Department Name: Health Information Management
Job Status: Full time, 40 hours per week
Shift: Monday to Friday 8am to 4pm. Remote

Duties & Responsibilities

POPULATION SPECIFIC CARE
No direct patient care.

ESSENTIAL FUNCTIONS
An employee in this position may be called upon to do any or all the following essential functions. These examples do not include all of the functions which the employee may be expected to perform.

* Writes and updates all work processes for coding to support the onboarding and cross training workflows for coding
* Trains and educates the Inpatient and/or Outpatient onboarding coding staff on all aspects of coding.
* Performs Inpatient and/or Outpatient coding audits to ensure coding accuracy and compliance. Provides feedback to the coders for continuous coding quality improvement.
* Researches coding questions for changes in regulatory compliance, and other topics using all available resources.
* Presents coding education to coders as part of yearly coding compliance plan based on external audit findings.
* Performs reconciliation of DRG and or charges with collaboration with Clinical Documentation Integrity, Coding Integrity, or Revenue Integrity for best practice.
* Performs full-level coding when needed, encompassing inpatient coding, entry and intermediate level coding, provider queries and aids coders with correspondence to faculty on documentation clarification.
* Provides one-on-one training for cross-training or coaching needs. Demonstrates an understanding of technology supporting all aspects of coding and technology serving as a SME in HIM projects as needed.
* Performs a second level review via request from various Revenue cycle teams to verify any code or charge for accuracy of coding prior to or post billing.

Minimum Qualifications

• Degrees
  • Associate's degree in healthcare or a related field.
    
    
• Experience
  • Five (5) years facility coding experience.
    
• Equivalency
  • Two (2) years of related experience, beyond stated requirements, may be substituted for the Associate's degree.
    
• Licenses & Certifications
  • One of the following is required: Certified Coding Specialist (CCS); Certified Professional Coder (CPC); Registered Health Information Administrator (RHIA); Registered Health Information Technician (RHIT)
    
• Competency

SCOPE & LEVEL
Guidelines: Guidelines are generally but not always clearly applicable, requiring the employee to exercise judgment in selecting the most pertinent guideline, interpret precedents, adapt standard practices to differing situations, and recommend alternative actions in situations without precedent.
Complexity: Duties assigned are generally complex and may be of substantial intricacy. Work assignment is performed within an established framework under general instructions but requires simultaneous coordination of assigned functions or projects in various stages of completion.
Decision Making: Exercises judgment and discretion, and is responsible for determining the time, place and sequence of the work performed.
Communications: Contacts with team members, clients or the public where explanatory or interpretive information is exchanged, defended, and gathered and discretion and judgment are required within the parameters of the job function.
Supervision Received: Performs work with minimal supervisory oversight. Under general supervision, the employee receives assignments and is expected to carry them through to completion with substantial independence. Work is reviewed for adherence to instructions, accuracy, completeness, and conformance to standard practice or precedent. Recurring work clearly covered by guidelines may or may not be reviewed.

Salary Information
Pay is dependent on applicant's relevant experience.

Hourly Range: $28.33 to $42.50

Benefits Information
Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.

EEO Statement
It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained.

Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.