The HIM Coding Audit Training Analyst Coordinator provides advanced training to hospital coding staff, compliance, CDI, physicians, and clinical staff. This Coordinator serves as a subject matter expert for all ICD-10 CM/PCS and CPT coding practices, conventions, regulatory, and reimbursement guidelines for the system. They audit and monitor all areas of hospital coding. The coordinator works with providers and clinical staff to make critical coding decisions based on incomplete, and ambiguous record documentation. They assist the coders in converting patient diagnoses and procedures documented by the providers in the EHR (Electronic Health Record) to ICD10/PCS and CPT codes at an advanced level of complexity. Essential Functions Provides advanced training to acute coders at all levels, providers, clinical staff, compliance and the CDI team. Audits and creates appeals for all payer and regulatory denials and downgrades and provides in-depth coding review, audit findings, and appeal strategies. Develops and implements training plans for all internal stakeholders including coders at all levels, providers, clinical staff, compliance and the CDI team. Audits clinical documentation and coding for complex internal and external coding questions Ensures that coded data accurately reflects the severity of illness, risk of mortality, and quality of care Performs audits including DRG (Diagnosis Related Groups), ICD-10 CM/PCS (Procedure Classification System), CPT, and PSI (Patient Safety Indicators) Analyzes data and collaborates with applicable stakeholders to identify aberrant coding patterns and trends. Participates in hospital quality improvement initiatives to assure accurate reimbursement Participates in integrated testing of Epic, Solventum, and other software
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Job Type
Full-time
Career Level
Mid Level