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Form of workPositions Location: Lansing, MI Job Description General Purpose of Job: The Remote Hospital Billing Coding Educator/Auditor will coordinate coding audits and education functions of Sparrow Health System coding services. This individual will be responsible for managing and working the edit and denial coding work queues for the inpatient and outpatient areas and will provide coding feedback for education opportunities identified to the coding team. This individual will also work with our CDI Team to identify coding opportunities from Mortality Review meetings and other areas.
Prepares and presents educational programs related to coding. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, reviews principal, secondary diagnoses and procedures for hospital services for Inpatient and Outpatient records based on knowledge of coding systems, including ICD-10 and CPT. Essential Duties: This job description is intended to cover the minimum essential duties assigned on a regular basis.
Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position. Develops, implements, and monitors account audit process for HB Coding Teams which includes all HB Inpatient and Outpatient Coding areas.
Educates HB Coding caregivers to improve and ensure quality and compliant coding. Designs, implements, and conducts effective training programs to support the hospital billing revenue cycle. Assists with identifying documentation needed for quality initiative programs.
Communicates opportunities for improved workflow to information technology and/or EPIC analysts. Identifies and implements coding opportunities to maximize reimbursement. Maintains standardized compliance with Sparrow compliance policies.
Reviews cases for accurate coding, monitoring the assignment and sequencing of ICD-10-CM/PCS and CPT codes to facilitate the correct assignment of diagnostic and procedure codes. Creates presentations, develops learning material, handbook and other training materials. Other projects as assigned.
Job Requirements General Requirements Certified Coding Specialist (CCS) or Registered Health Information Management Technician (RHIT) or Registered Health Information Administrator (RHIA). Member of the AHIMA in good standing (i.e., has paid dues and completed required continuing education) Work Experience Minimum three (3) years of Inpatient hospital billing coding experience in a large complex health system, which includes hospital coding, denial review, and/or coding education functions. Minimum three (3) years of Outpatient hospital billing coding experience in a large complex health system, which includes hospital coding, denial review, and/or coding education functions.
Education Associates degree in Health Information Management, RHIT, RHIA or CCS Bachelors degree in Health Information Management, RHIT, RHIA or CCS - preferred Specialized Knowledge and Skills Demonstrates knowledge of ICD-10-CM and CPT-4 Working knowledge of reimbursement methodologies including Diagnosis Related Groups Good communication skills MS Office experience (Word, Excel, and PowerPoint) - preferred Electronic Medical Record - preferred Sparrow Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.
