Professional Coding Quality Auditing Coordinator

Additional Information About the Role

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.

BJC Health Care is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14hospitals and multiple community health locations.

Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.

BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.

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.

• 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…