Auditor/Educator Inpatient

Seeking a FT inpatient auditor to validate DRGs, Pdx, MCC, CC, SOI, ROM, POA, PCS, and DD.  Must have a minimum of 2 years of recent IP auditing experience and least 5 years of experience of prior IP coding experience.  Must be experienced with auditing cases from an academic university health system and trauma level 1.  Must be comfortable with reviewing cases from all specialties. Must have experience with Cerner and 3M. Prior to access being granted approx. 4 hours of learning modules must be completed, any candidate applying must be able to comment getting done within 48 hours of being released to the candidate. Candidate will be paid for the time.  Schedule can be flexible within reason, but for initial training (1-2 weeks) must be available for a couple hours between 8a and 4p Mountain Time each day. 

Summary/Objective 
For assigned coders and providers, review Inpatient, Outpatient or Professional Fee medical records for coding accuracy and medical record documentation as it impacts the correctness of the coding. Provide feedback and deliver additional education to correct inaccurate coding and improve documentation. 

Essential Job Functions 

• Review medical records for accuracy of coding and data quality. Elements included in reviews may include: 
•     All diagnosis and procedure assigned ICD-10-CM and ICD-10 PCS codes 
• Evaluation and Management, CPT, HCPCS 
• Physician Documentation Gaps 
• Adherence to Guidelines 
• Teaching Physician Attestations 
• Clinician Signature Validation 
• Use relevant references to perform the Current Procedural Terminology (CPT-4) Official Coding Guidelines, Coding Clinic, CPT Assistant, CMS guidelines, etc. 
• Communicate effectively with client management, coders, and providers. Provide information regarding work progress, actions, and issues in a timely and effective manner. 
• Create an action plan that articulates strengths and areas that may require ongoing development to ensure an effective and successful program. 
• Assist in creating additional learnings that addresses coding problems and documentation gaps. 
• Solicit feedback from program participants regarding training content or delivery enhancements that would further improve coder/provider effectiveness. 
• Capitalize on electronic delivery avenues. 
• Make recommendations to training content, length, delivery, or other aspects of training based on evaluations and feedback from HIM organization/Provider practice.  
• Keep abreast of training and development research such as learning theory, motivation theory, and new materials, methods, and techniques. 
• Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance. 

Key Success Indicators/Attributes 

• Ability to prioritize and multi-task in a fast-paced, changing environment. 
• Ability to speak and educate providers face to face. 
• Demonstrate ability to work in all work types and specialties. 
• Demonstrate ability to self-motivate, set goals, and meet deadlines. 
• Demonstrate leadership, mentoring, and interpersonal skills. 
• Demonstrate excellent presentation, verbal, and written communication skills. 
• Ability to develop and maintain relationships with key business partners by building personal credibility and trust. 
• Maintain courteous and professional working relationships with employees at all levels of the organization. 
• Demonstrate excellent analytical, critical thinking and problem-solving skills. 
• Skill in operating a personal computer and utilizing a variety of software applications. 
• Strong presentation skills with an ability to effectively communicate concepts, terminology, and practices.  
• Capable of delivering training using multiple media, conducting role plays, assessing progress, and measuring training effectiveness.  
• Demonstrated leadership and problem-solving skills, plus the ability to act/decide accordingly and take initiative.  
• Ability to collect, create and research complex or diverse information.  
• Exceptional customer service skills and the ability to plan, organize and exercise sound judgment.  
• Ability to be positive and flexible in a fast-paced work environment, support management decisions, take responsibility for own actions, lead others to achieve goals, and follow through on commitments. 
• Strong presentation and written communication skills with an ability to effectively communicate concepts, terminology, and practices.  
• Capable of developing and delivering training using multiple media, conducting role plays, assessing progress, and measuring training effectiveness.  
• Strong systems aptitude with a customer orientation and flexibility in work practices.  
• Ability to work effectively, independently and as part of a team 

Supervisory Responsibility 

None 

Work Environment 

This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and phones. 

Physical Demands 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. 

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus. 

Position Type/Expected Hours of Work 

This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work. 

Travel 

Some travel required; up to 80% 

Required Education and Experience 

• Minimum 5 years’ experience in Coding and HIM operations with progressive responsibilities and at least 3 years’ experience in auditing and delivering feedback. Prior experience delivering training related to this field.  
• Strong working knowledge of Coding terminology, guidelines, diagnostic and procedural codes, and exposure to delivering training through demonstrated past successes.  
• Bachelor’s Degree in HIM or equivalent or a combination of advanced formal training and relevant experience.  
• CCS, CCS-P, CPC, CPC-P, CPC-H, RHIA or RHIT certification 
• Working knowledge of Microsoft products (such as PowerPoint, Word, Excel, Visio, and Publisher) for creating training materials. 

Preferred Education and Experience 

Experience with e-learning coding software (such as Relias), a plus 

Additional Eligibility Qualifications 

N/A 

Other Duties 

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.  Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned. 

Qualifications

1. 2+ years of recent IP auditing experience
2. 5+ years of previous IP coding experience
3. Cerner and 3M experience
4. Academic and Trauma 1 experience
5. Able to maintain 95% accuracy in reviews
6. Good verbal and written communication skills
7. Experience with MS Excel 

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com

We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.

AAP/EEO Statement

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at [email protected].