Coding Quality Audit Inpatient Coordinator

Coding Quality Audit Inpatient Coordinator

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.

BJC's patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children's Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.

Preferred Qualifications

The Inpatient Coding Quality Auditor is responsible for second level coding audits and real time education supporting on-going quality assurance activities for the Coding Department. Quality audits are inclusive of assessing compliance with federal and state regulatory coding guidelines, focusing on appropriate assignment of all diagnoses, procedures and DRG's to ensure accurate coding for reimbursement and clinical services (Quality Measures, Severity of Illness, Risk of Mortality). Coding auditing and education encompasses all the Inpatient services of our large health system including critical access, community and Academic hospitals (pediatric and adult). Audit findings are analyzed to identify risk areas and develop educational materials. Educational materials may include individualized coder development plans, regulatory updates, or for cause education to support BJC as a best-in-class organization.

Responsibilities

• Serves as subject matter and decision support experts for Enterprise Coding. Actively participates in committees, project teams and other meetings to support issue resolution, process improvement and process development. Proactively identifies issues or trends and reports to Coding Leadership as appropriate.
• Completes timely and accurate quality assurance coding audits in accordance with IPPS using ICD-10-CM and ICD-10 PCS Coding Classification Systems. Adheres to federal and state regulatory and payer guidelines. Translates quality auditing results into practical and actionable recommendations for improvements in further standardizing audit policies and procedures.
• Develops and delivers focused coding education, training plans and tools to address areas at risk, regulatory updates, and continuous opportunities for improving coding and compliance outcomes.
• Builds and maintains collaborative relationships intradepartmentally as well as with CDI, Quality, Compliance, Revenue Management, providers and other departments as appropriate.

Minimum Requirements

• Education: High School Diploma or GED
• Experience: 2-5 years
• Licenses & Certifications: Registered Health Info Admin, RHIT, CCS

Preferred Requirements

• Education: Associate's Degree, Bachelor's Degree
• Experience: 5-10 years
• Supervisor Experience: No Experience

Benefits and Legal Statement

BJC Total Rewards

At BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance* paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

To learn more, go to our Benefits Summary.

*Not all benefits apply to all jobs

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer