Auditor/Educator In/Outpatient Position Available In Palm Beach, Florida

Auditor/Educator In/Outpatient OMH HealthEdge Holdings Boca Raton, FL Job Details Estimated:

$55.6K – $70.4K a year 1 day ago Qualifications Mid-level ICD-10 Analysis skills CPT coding Clinical documentation improvement Medical terminology Communication skills

Full Job Description Essential Job Functions:

Initial Audit and Education:

For assigned coding staff, conduct initial quality audits as they go through onboarding process for new project / client assignment, and provide education to staff based on initial quality audit findings. Review medical records for accuracy of coding and data quality. Elements included in reviews may include: CDI audit reviews

Auditing:

Reviewing me dical reco rds, including clinical notes, lab results, and other diagnostic information, to ensure documentation accurately reflects diagnoses, severity of illness, and risk of mortality.

Compliance:

Ensuring documentation complies with regulatory requirements, coding guidelines, and payer rules.

Identifying Gaps:

Identifying missed documentation opportunities, inconsistencies, and areas where documentation can be more specific or clarified.

Query Review:

Evaluating the appropriateness of queries issued to physicians, ensuring they are supported by clinical evidence and aligned with coding guidelines.

Data Analysis:

Analyzing data related to CDI performance, identifying trends, and reporting findings to leadership.

Education and Training:

Providing education and training to CDI staff, physicians, and other healthcare professionals on documentation best practices, coding guidelines, and regulatory requirements.

Skills and Qualifications:

Clinical Knowledge:

Strong understanding of disease processes, clinical conditions, and medical terminology.

Coding Knowledge:

Familiarity with ICD-10-CM/PCS, CPT, and other relevant coding systems.

CDI Experience:

Experience in clinical documentation integrity, including chart review and query writing.

Analytical Skills:

Ability to analyze data, identify trends, and make recommendations for improvement.

Communication Skills:

Excellent written and verbal communication skills to effectively communicate with various healthcare professionals. Inpatient /Observation Cases All diagnosis and procedure assigned ICD-10-CM and

ICD-10 PCS

codes Discharge disposition assigned Assigned Present on Admission (POA) indicators APR-DRG, MS-DRG, SOI, and ROM assignment for inpatient cases Appropriateness of queries created Outpatient Cases (ER, SDS, Ancillary) All diagnosis and procedure assigned ICD-10-CM and

ICD-10 PCS

codes All CPT assigned codes Modifier use and assignment APC assignment