Divisional Coding Quality Auditor & Educator

The Divisional Coding Quality Auditor & Educator is responsible for supporting the operations of the inpatient or outpatient coding teams by completing overall and account-level quality reviews of coding functions

• Completes timely and accurate quality assurance audits while adhering to inpatient and/or outpatient coding policies, procedures, and established audit schedule
• Translates quality auditing results into practical recommendations for improvements in further standardizing audit policies and procedures
• Provides outcomes of coding quality audit reviews with leadership
• Maintains current knowledge of coding principles and guidelines as coding conventions are updated
• Assists with the facilitation of scheduled external audits
• Responds to inpatient or outpatient coding questions from assigned coders/providers and provides official inpatient coding references and guidelines
• Creates clear and accurate audit findings and recommendations in written audit reports
• Provides feedback to coding and CDI team members on escalated accounts
• Collaborates with providers, AH Clinical, CDI, inpatient and outpatient coding staff to assist with or resolve issues relating to medical record documentation and coding
• Provides feedback on the application of coding guidelines, practices, and proper documentation techniques, and data quality improvements
• Provides input on which quality audit and metrics will be tracked and visualized on shared dashboards to report outcomes and improve processes and workflows
• Serves as point person for regional HIM/Coding teams to support quality audits and develop/maintain reports, scorecards and dashboards
• Flags data or analytics limitations, employs critical thinking and creative problem solving to address barriers, and escalates issues to leadership when appropriate
• Documents and presents findings and trends from the quality audits to the HIM/Coding leadership
• Reports any compliance and/or risk issues to the compliance department
• Provides suggestions on process improvement
• Works with the audit team and coding manager to develop meaningful education and may conduct educational huddles for inpatient coders across the organization
• Makes recommendations to corporate coding leaders for coding policy/guideline changes, based on trending quality issues
• Works with Epic and AIT to identify automation and system enhancements as they pertain to coding

• Completion of a coding certificate program
• 5 years experience coding acute care hospital chart
• Thorough understanding of coding processes and workflows
• Expert level knowledge of disease pathophysiology and drug utilization
• Expert level knowledge of Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI), and Hierarchical Condition Categories (HCC)
• Expert level knowledge of medical terminology, coding guidelines and methodologies
• Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature
• Proficient in MS Office (Word, Excel, PowerPoint, Visio, Outlook, etc.) and familiarity with database programs
• Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient manner
• Ability to communicate professionally and effectively in English, both verbally and in written form
• Ability to follow complex instructions and procedures, with close attention to detail
• Epic experience
• Certified Coding Specialist or Registered Health Information Administrator or Registered Health Information Technician

• Benefits from Day One
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support

AdventHealth is a faith-based health care organization headquartered in Altamonte Springs, Florida