Revenue Cycle Auditor-Educator CDI

Where You’ll Work

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

Job Summary and Responsibilities

This is an advanced level position with expert knowledge of current ICD (diagnostic and procedural) and CPT-4 coding classification systems. Responsible for answering coding and billing questions, onboarding and training new staff, performing coding/DRG validation audits, and development and deployment of coding and CDI education. Works in conjunction with the coding and CDI leadership team in planning and performing education and training across the system. Responsible for performing internal audits and follow up education. Facilitates and promotes standardization of coding/CDI practices, monitors and communicates regulatory coding and billing changes for timely and accurate implementation. Acts as a liaison between CDI, physicians, clinical quality, patient financial services, and other departments to ensure collaborative relationships resulting in accuracy and integrity of the inpatient medical record.

• Completes initial medical records reviews within 24-48 hours of admission for a specified patient population to evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality and severity of illness.
• Conducts follow-up reviews every 2-3 days to support working DRG assignment.
• Formulates compliant provider queries regarding missing, unclear or conflicting documentation, as necessary.
• Follows up daily on open queries with providers to ensure timely responses. Reviews final coding DRG assignment follows DRG reconciliation process.
• Keep abreast of Official Coding and Reporting Guidelines, AHA Coding Clinics, CMS and other agency directives and maintains up to date knowledge of coding and CDI current trends.
• Strong oral communication skills and the ability to deliver presentations to large groups

Job Requirements

Required

• Associates Other Associates degree in Nursing and or HIM related fields or 4-6 years Five (5) years coding auditing experience including but not limited to hospital inpatient and outpatient encounters, upon hire and
• Six (6) years of experience in coding quality audit work or record review including but not limited to hospital inpatient and outpatient., upon hire and
• Certified Coding Specialist, upon hire or
• Certified Professional Coder, upon hire or
• Registered Health Information Administrator, upon hire or
• Registered Health Information Technician, upon hire or
• Clinical Documentation Improvement Professional, upon hire

Preferred

• Associates Other in relevant field or combination of equivalent of education and experience., upon hire