NACCHO.

  • Nashville, TN


  • Irreversible.

  • Full-time.
Description

Lead Coding Auditor (Peds/Psych exp)

TASK SUMMARY:

Provides management in sharing existing and appropriate coding topic know-how with personnel. Carries out audits of inpatient and/or outpatient coding. Understands and uses quality standards to all elements of the paperwork integrity program. Recognizes locations for strategic audits, coding education and improvement. Supports rejections management process and other efforts.

SECRET RESPONSIBILITIES:

  • Reviews documents to ensure assigned codes are supported. Acknowledges paperwork clarification chances and deals with group to secure additional paperwork.
  • Assigns codes that the majority of properly reflect documentation of the client stay, seriousness of illness, risk of mortality, and resources used during the patient encounter.
  • Composes descriptions to support or rebut coding recommendations and appeals for denied or downcoded encounters.
  • Participates in accurate data collection, analysis, examination, problem fixing and suggestions of procedure improvements.
  • Carries out pre and post-bill evaluations, qualitative review and prospective 3rd party payor reviews based upon identified concerns. Performs prebill reviews and education for brand-new coders.
  • Performs information analysis of the audit program, findings, and other source information, to determine trends and patterns. Creates detailed reports based upon audit findings and facilitates change procedures.
  • The duties noted are a basic overview of the position and additional responsibilities may be appointed.

TECHNICAL ABILITIES:

MEDICAL CODING (EXPERT): – The transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.

MEDICAL TERMINOLOGY & DOCUMENTATION (PROFESSIONAL): – The capability to comprehend medical terminology and documents in an office, or surgical setting.

CRITICAL THINKING (ADVANCED): – The unbiased analysis and evaluation of a problem in order to form a judgment.

COMPLIANCE (ADVANCED): – Comprehending the rules, regulations, sanctions and other statutory requirements, guidelines and directions associating with governing bodies and organizations, both internally and externally.

WRITTEN COMMUNICATION (ADVANCED): – Shows the capability to compose clear, comprehensive, and extensive status reports, memos and documents. Demonstrates an understanding of reliable composition, such as having first line in a paragraph state the subject.

VERBAL COMMUNICATION (ADVANCED): – Ability to articulate plainly, using appropriate voice control and body language. Efficiently sends technical and service concepts and details to others. Listens carefully to determine points being made before attempting to be understood.

PEER MANAGEMENT (INTERMEDIATE): – The capability to show management and affect individuals of equivalent rank in an effort to accomplish group goals.

CORE ACCOUNTABILITIES:

  • Organizational Effect: Delivers projects/assignments that have a direct influence on goals/objectives of the unit/department that the job remains in.
  • Issue Resolving/ Intricacy of work: Conducts extensive analysis of circumstances or data to deal with various, complicated concerns; might involve the input/work of others.
  • Breadth of Understanding: Has in-depth level of understanding within an expert location and working knowledge of other areas.
  • Group Interaction: May lead mid-sized projects; coaches and guides staff member.

NACCHO.

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