Coding Compliance Auditor

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager.

Job Description

Minimum Qualifications

Education:  High school diploma or GED, required

Licenses/Certifications:

Inpatient - Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), or Certified Inpatient Coder (CIC) Coding Certification(s) from American Health Information Management Association (AHIMA) or American Association of Professional Coders (AAPC) required.

Outpatient - Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or relevant Coding Certification(s) from American Health Information Management Association (AHIMA) or American Association of Professional Coders (AAPC) required.

Experience / Knowledge / Skills:

• Four (4) years of relevant hospital coding or auditing experience required.

• Experience coding/auditing in a level 1 trauma facility/academic teaching facility strongly preferred

• Extensive knowledge of ICD-10-CM and CPT coding principles and guidelines.

• Extensive knowledge of 3M Coding applications and resolving coding edits.

• Working knowledge of reimbursement systems and regulations and policies pertaining to documentation, coding, and billing.

• Knowledge of database applications and spreadsheet design.

• Effective oral and written communication skills.

Principal Accountabilities

• Conducts regular coding audits and coordinates ongoing monitoring of coding accuracy, providing continuous feedback to coding staff.

• Develops and coordinates educational sessions to all coding staff regarding documentation and accurate coding.

• Serves as a resource for coding staff on organization-wide coding and documentation standards and guidelines.

• Designs audit tools to monitor the accuracy of clinical coding.

• Keeps abreast of coding guidelines and reimbursement reporting requirements.

• Conducts trend analyses to identify patterns and variations in coding practices.

• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.

• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.

• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.

• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.

• Other duties as assigned.

Employee Signature:________________________________________ Date:_________________

Manager Signature:_________________________________________ Date:_________________

Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the patient served.  Must demonstrate knowledge of the principles of growth and development as it relates to the different life cycles.  Specific age groups that are served by this position are circled:

|      Neonate      |         Infant         |      Pediatric      |    Adolescent    |         Adult         | Adult/Geriatric |