Professional Coding Quality Auditing Coordinator

Overview

BJC Professional Coding Quality Auditing Coordinator. Remote position, but must located in MO or IL.

This CQC applicant will need to have 2-5 years' experience coding Professional Evaluation and Management coding (E/M) plus surgical coding (Cardio/Ortho/ENT, OBGYN/General Surgery), auditing experience, and educating providers/coders experience. This candidate must be CPC, CCS, or RHIT certified. This candidate will be providing E/M and surgical audits for our coders and our providers at the Medical Group so their knowledge of coding and auditing these services would help make them a successful candidate.

Role Purpose

The Professional Coding Quality Audit Coordinator is responsible for second level coding audits and real time education supporting the ongoing quality assurance activities for the Coding Department and providers. Quality audits are inclusive of assessing compliance with federal and state regulatory coding guidelines, focusing on appropriate assignment of all diagnoses, procedures and E/M Levels to ensure accurate coding for reimbursement and clinical service (Quality).

Coding auditing and education encompasses all the Ambulatory/Professional services for the Medical Group of our large health system including hospital based and office encounters. Audit findings are analyzed to identify risk areas and develop educational materials. Educational materials may include individualized coder or provider development plans, regulatory updates, or for cause education to support BJC as a best in class organization.

Responsibilities

• Serves as subject matter and decision support experts for Enterprise Coding. Actively participates in committees, project teams and other meetings to support issue resolution, process improvement and process development. Proactively identifies issues or trends and reports to Coding Leadership as appropriate.
• Develops and delivers focused coding education, training plans and tools to address areas at risk, regulatory updates, and continuous opportunities for improving coding and compliance outcomes.
• Completes timely and accurate quality assurance coding audits in accordance using ICD-10-CM and CPT/HCPCS Coding Classification Systems. Adheres to Ambulatory federal and state regulatory and payer guidelines. Translates quality auditing results into practical and actionable recommendations for improvements in further standardizing audit policies and procedures.
• Builds and maintains collaborative relationships intradepartmentally as well as with providers, Compliance, Revenue Management, and other departments as appropriate.

Education

• High School Diploma or GED

Experience

• 2-5 years

Supervisor Experience

• No Experience

Licenses & Certifications

• RHIT, CCS or CPC
• Registered Health Info Admin

Education

• Associate's Degree
• Bachelor's Degree

Experience

• 5-10 years

BJC Total Rewards

At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance
  * paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

To learn more, go to our Benefits Summary

* Not all benefits apply to all jobs

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer