What is the role of a IP Coder/Auditor at Good Shepherd Rehabilitation Network?

The IP Coder/Auditor position at Good Shepherd Rehabilitation Network is a Full-time or part-time position opportunity in the relevant field.

Where is this IP Coder/Auditor job located?

Allentown, Pennsylvania, 18103, United States

What type of employment is offered for this IP Coder/Auditor role?

Full-time or part-time position

What industry does this IP Coder/Auditor position belong to?

This role spans multiple industries.

What is the expected salary for this IP Coder/Auditor job?

Compensation will be discussed during the hiring process.

How can I apply for the IP Coder/Auditor position at Good Shepherd Rehabilitation Network?

You can apply directly through the application link provided.

IP Coder/Auditor at Good Shepherd Rehabilitation Network

JOB SUMMARY
- Reviews patient records, assigns diagnostic and procedural codes, performs related functions and participates in Performance Improvement activities.
ESSENTIAL FUNCTIONS
- DIAGNOSTIC CODING OF ALL MEDICAL RECORDS REPORTED ON PATIENT BILLS
  - By coding all diagnoses, treatments, and procedures according to the appropriate classification system for the category of patient encounter
  - By accurately coding all inpatient records in accordance with ICD-10 CM/PCS coding rules and guidelines in a timely manner with a 95% accuracy rate
  - By following approved coding conventions, assigns diagnostic and procedural codes to inpatient records
  - Reviews AHA Coding Clinic and demonstrates the ability to accurately apply new coding guidelines.
  - Researches new diagnostic and procedure codes as required performing the coding function.
  - Informs coding supervisor of trends and opportunities for improvement in clinical documentation.
  - Works collaboratively with other coders.
  - Adheres to the American Health Information Management’s Code of Ethics.
- LOCATES MEDICAL RECORDS THAT REQUIRE CODE ASSIGNMENT
  - By searching master patient index; identifying location of existing patient records and obtaining the documentation required for code assignment.
- MAINTAINS MEDICAL RECORDS OPERATIONS
  - By following policies and procedures; reporting needed change
- RESOLVES MEDICAL RECORD DISCREPANCIES
  - By acting as a resource to other staff on coding issues
  - By assisting the physicians with documentation improvement via the diagnostic query form
  - By collecting and analyzing information
- MAINTAINS HISTORICAL REFERENCE
  - By abstraction and data entry of all inpatient records into the Good Shepherd Hospital computer system for clinical and financial purposes
  - By abstracting and coding clinical data, such as diseases, procedures, using standard classification systems.
  - By providing DRG/CMG forecasting information to Nurse Liaison as needed.
  - By accurately assigning the correct principal diagnosis on LTCH and rehab accounts.
  - By performing weekly/bi-weekly concurrent chart reviews for any potential DRG/CMG changes during the patient stay.
  - By coding all discharged charts timely and accurately
- PROVIDES MEDICAL RECORD INFORMATION
  - By providing codes for billing and answers questions from hospital staff
  - By assisting physicians and other direct patient care professionals in questions regarding level of detail for diagnostic entries, according to the organization’s guidelines
- MAINTAINS THE STABILITY AND REPUTATION OF THE HOSPITAL
  - By complying with legal requirements.
- SUPPORTS REGULATORY AUDIT PROCESSES (E.G. RCD, RAC, ADR, ETC)
- PROVIDE SUPPORT TO REVIEW CHOICE DEMONSTRATION (RCD) AUDITOR COORDINATOR AS NEEDED AND BIWEEKLY WEEKEND/VACATION COVERAGE
- Completes Medical Record Audits
  - Accesses and runs automated audit tool via facility’s EMR to determine elements out of compliance via standard work process.
  - Reviews documents for completion, guided by CMS rules and regulations.
- COMMUNICATES AUDIT RESULTS
  - Communicates document compliance to appropriate providers and extenders of documentation status for compliance and improvement.
  - Upon record audit completion, sends records to manager to second level review and approval in a timely manner.
  - Communicates daily with Director of Revenue Compliance regarding audit progress, issues, other departmental work timelines, priorities, etc.
  - Communicates effectively with colleague stakeholders to inform them of potential issues identified and receive updated documentation that meets CMS standards.
- SUBMITS/REPORTS/AUDIT RESULTS TO/FROM CMS
  - Prepares documents for initial upload and resubmissions to CMS via Novitasphere.
  - Manages daily communication of results and status with CMS and RCD team.
- PROVIDES ADMINISTRATIVE SUPPORT
  - Manages and updates audit results via smartsheet tool.
  - When issues are identified, problem solves the reason and initiates solutions (communicating to providers, escalating to Director of Revenue Compliance, etc.) to a goal of 100% compliance of medical record files.
QUALIFICATIONS:
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  - Education
    - High School Diploma required
    - Completion of the AHIMA independent study program preferred
  - Work Experience
    - 2-4 years of inpatient coding experience utilizing ICD-9-CM and/or ICD-10-CM/PCS required
  - Licenses / Certifications
    - RHIA, RHIT, CCS, CPC, active member in AHIMA preferred

IP Coder/Auditor at Good Shepherd Rehabilitation Network – Allentown, Pennsylvania

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