Director, Coding Auditor & Educator

Director, Coding Auditor & Educator (7410-2297) LifePoint Health Support Center Description The Director, Coding Auditor and Educator is responsible for reviewing and auditing hospital medical records for coding completeness and accuracy. This position identifies potential coding and DRG errors and researches appropriate coding guidelines to support recommended changes. It communicates these changes in a timely manner, provides coding education and expert coding advice to the coding staff, and develops education/training materials including coding guidelines, policies and procedures. The role demonstrates proficiency in auditing principles (including re‑auditing) and communicates with IRM, Group Leadership, Ethics and Compliance Department members, hospital HIM coding and DI regarding audit issues, current coding regulations and utilization review concerns. The director stays abreast of current coding regulations, admission review requirements, professional standards, company and department policies and procedures and effectively applies this knowledge. Immediate Supervisor: VP, Clinical Revenue Integrity General Responsibilities Performs coding quality audits and special project reviews. Reviews claim denials and rejections pertaining to coding and medical necessity issues and implements corrective action. Develops coding quality audit reports (memo, executive summary, audit findings, and action plan). Analyzes data, identifies trends and conclusions (e.g., coding practices, case‑mix changes) and proposes strategies for resolution and education opportunities. Provides education support on documentation, coding, billing and utilization review management. Prepares and presents educational programs related to coding. Stays abreast of coding and billing requirements, company/department policies and procedures to effectively apply this knowledge to complex coding quality and compliance situations. Proactively recommends action for improving coding compliance. Serves as resource for department managers, staff, physicians and administration to obtain information or clarification on accurate and ethical coding and documentation standards, guidelines and regulatory requirements. Maintains open dialogue, promotes collaboration and good working relationships with all members of the HSC and hospital teams. Performs other department duties as assigned. Qualifications Associate or Bachelor degree in Health Information Management. RN with CCS, preferred. Minimum 3–5 years of hospital coding, including knowledge of 3M coding/grouper. Knowledge of federal, state and payer‑specific regulations and policies pertaining to documentation, coding and billing. Proficient with Microsoft software (Word, Excel and PowerPoint). Knowledge of Medicare and all payer reimbursement methodologies. Knowledge of utilization management techniques. Familiar with audit management techniques. Self‑motivated; able to work within established policies, procedures and practices prescribed by the Company and the immediate supervisor. Works with deadlines and related time pressure. Knowledge of statistics, data collection, analysis, and data presentation. Excellent interpersonal communication and problem‑solving skills. Excellent written and oral communication skills. Travel 40% of the time. Physical Demands/Working Conditions Requires prolonged sitting and some bending, stooping, and stretching. Requires eye‑hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment. Requires normal range of hearing and eyesight to record, prepare, and communicate appropriate reports. Requires lifting papers or boxes up to 50 pounds occasionally. Work is performed in an office environment and involves frequent contact with staff and the public. Equal Opportunity Employer LifePoint Health, Inc. is an Equal Opportunity Employer. EOE Minorities/Females/Protected Veterans/Disabled. #J-18808-Ljbffr LifePoint Health