HIM Coding Quality Officer , Remote

Job Details

Job Title: HIM Coding Quality Officer I, Remote

Req #:

Category: Information Technology and Systems / Clinical Informatics

Status: Full-Time

Shift: Day

Facility: RWJBarnabas Health Corporate Services

Department: HIM - Coding Quality

Pay Range: $75,597.00 - $ per year

Location: 2 Crescent Place, Oceanport, NJ 07757

The Quality Officer I is responsible for ensuring accuracy and integrity of ICD-10-CM/PCS coding and DRG assignment for inpatient encounters for other payers (not Medicare/Managed Medicare). This requires critical thinking and a skill set above what is expected as a coder. Quality Officers must also sustain an excellent organizational average accuracy rate. Adherence to applicable Federal and State Regulations, Compliance Guidelines, and Coding Guidelines set forth by RWJBH, American Hospital Association (AHA) and the American Medical Association (AMA) must be maintained.

Required:

• CCS required
• ICD-10-CM/PCS proficiency required
• Bachelor's degree or equivalent in experience
  • 4+ years acute care coding and/or auditing experience with a Bachelor's degree
  • 7+ years acute coding and/or auditing experience required without a Bachelor's degree
• Extensive knowledge of ICD-10-CM/PCS and CPT coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology
• Knowledge of billing and coding regulations
• Must have excellent interpersonal, oral, and written communication skills. Must be capable of critical thinking and analysis and written conveyance of same.
• Must have excellent organizational and time management skills
• Must maintain a professional demeanor
• Must be able to work independently and cooperatively with minimal supervision
• Must foster positive relationships with fellow co-workers and the coding team

Preferred:

• CPC-H, RHIT, RHIA and/or RN also encouraged

• Monday-Friday, 40 hour a week salaried position
• 8:00am-4:30pm
• Remote; must reside in NJ, PA, or NY

• Ensures the accuracy and integrity of ICD-10-CM/PCS, CPT coding when applicable and DRG assignment for adherence to Federal and State Regulations and Compliance Guidelines.
• Critically analyzes each inpatient medical record to apply appropriate coding, DRG judgments, SOI, ROM and POA.
• Independently manages SMART pending queues for all acute care RWJBarnabas facilities and reviews ICD-10-CM/PCS coding and DRG assignment of medical records flagged by SMART.
• Manages EPIC SMART WQ's to assure proper workflow of identified accounts.
• Directs coders with case-specific recommendations and educates/coaches on coding principles, code assignment and sequencing. Educates new facilities to ensure a unified methodology within RWJBH.
• Sustains an excellent organizational average accuracy rate by leveraging advanced knowledge of coding practices.
• Quality analysis is reviewed by Coding Specialists on a biannual basis; incorrect judgments may lead to increased monitoring and productivity actions.
• Productivity standards must be met; non-compliance may result in disciplinary action.
• Monitors SMART queues to ensure records are reviewed and directed appropriately, and released to billing as appropriate within timelines.
• Works as a team with other Quality Officers to meet SMART review goals for RWJBarnabas facilities.
• Reviews discharge status, admission/discharge dates, and related demographic information for accuracy; communicates needs for Case Management review when appropriate.
• Reviews POA indicators for all coded diagnoses for accuracy and completeness.
• Reports system problems to RWJBarnabas IT&S or SMART helpdesk for resolution and maintains records of review activity.
• Communicates coding recommendations and rationale to the Coding team; performs regulatory coding research as needed.
• May be required to perform other related duties.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees' physical, emotional, social, and financial health.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

RWJBarnabas Health is an Equal Opportunity Employer