Coding Compliance Auditor Team Lead- Educator

Auditing Team Lead

Under direct supervision, the Auditing Team Lead provides day to day supervision and instruction of the auditors. The Auditing Team Lead oversees the internal and external auditing function and assists Director Inpatient Coding, Coding Audits, and Education in developing reports specific to audit findings and assists with implementing action plans. The Auditing Team Lead ensures internal audits are accurate, complete and reported on a timely basis and serves in an advisory and educator role for Coding Specialists.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Provides for day to day supervision and instruction for the auditors which includes audit assignments, problem solving, monitoring productivity and scheduling. Manages time and attendance approvals.

a. Monitor auditors assigned work on a daily basis in order to facilitate completion of all audits on a timely basis.

b. Maintains appropriate coverage for associated workload.

c. Monitors auditing productivity and performs quality audits of the auditors' work to ensure accuracy and consistency of audit recommendations and reports and holds associates accountable for their performance.

2. Serves as a clinical coding subject matter expert and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.

a. Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations.

b. Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment.

3. Oversees the internal auditing function and ensures internal audits are accurate, complete and reported on a timely basis. Organizes external audits and assists to resolve inquiries/issues arising from external audit process.

a. Serves in an advisory and educator role for Coding Specialists. Serves as communicator between Clinical Documentation Specialists and Coding. Researches new surgical procedures and technology.

b. Reports coding quality accuracy rate for each coder

c. Organizes and conducts specialized focused audits as needed.

d. Assists manager in hiring process, orientation and training new auditor on site specific requirements.

e. Provides input in performance evaluations and coordinates with manager when corrective actions are needed.

f. Provides an open and goal-oriented work environment with established clear and concise work procedures and productivity standards. Communicates any employee relation matters to manager as warranted.

6. Communicates with various departments within the hospitals regarding coding accuracy. Refers any problems to management timely, providing clear details. Assist coding specialists in writing appropriate coding queries, works collaboratively with CDI, understand Potentially Preventable Complications (PPC's)/Maryland Hospital Acquired Conditions (MHAC's), Prevention Quality Indicators (PQI's) and their impact and other indicators as needed.

7. Maintains auditing quality accuracy rate of 90%.

8. Maintains productivity rate of 95%.

9. Complies with AHIMA standards of ethical coding and coding compliance guidelines.

10. Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager.

Education and Experience

1. Associates degree or 7 years' total experience required. Bachelor's degree in related field preferred.

2. Minimum of 5 years ICD-10-CM/ICD-10-PCS coding and abstracting experience at a Level 1 Trauma hospital or 7 years of experience with coding inpatient hospital medical records required. Five (5) years Ambulatory coding experience.

3. One of the following required: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC). Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) preferred.

Knowledge, Skills and Abilities

Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.

Benefits

All your information will be kept confidential according to EEO guidelines.

Compensation: Pay Range: $36.83-55.29

University of Maryland Medical Center