Job Information
RWJBarnabas Health System Inpatient Coding Audit and Query Manager - West Orange, NJ in West Orange, New Jersey
System Inpatient Coding Audit and Query Manager - West Orange, NJReq #:0000166649
Category:Professional / Management
Status:Full-Time
Shift:Day
Facility:RWJBarnabas Health Corporate Services
Department:HIM - Coding North
Location:
SBC Corporation, 95 Old Short Hills Road, West Orange, NJ 07052
Job Overview:
The System Inpatient Audit and Query Manager is responsible for auditing hospital encounters to ensure ongoing quality regarding accurate inpatient coding, abstracting, data entry, discharge disposition, POA indictors and DRG assignment. This position will also oversee the physician query process for appropriate submission.
Qualifications:
Required:
Must have at least one of the following credentials: RHIA, RHIT, or CCS, with at least 8-10 years of coding experience.
Must have three to five years of experience in auditing with demonstrated knowledge of DRGs, documentation requirements and current coding guidelines.
Must have extensive knowledge of MS DRGs, APR DRGs, APCs, Official Coding Guidelines, and a broad-based and thorough understanding of ICD-10 CM, PCS coding and CPT/HCPCS systems.
Must have in depth knowledge of Coding processes, workflow management and electronic health records.
Must be proactive and work independently to prioritize multiple tasks and changes in work assignment to meet established deadlines.
Must be able to work in a fast-paced healthcare environment, work well under pressure and have the ability to adapt to a constantly changing environment.
Essential Functions:
Ensures accuracy and integrity of ICD-10-CM Coding and DRG assignment for inpatient accounts for the purpose of maintaining compliance with Federal and State Coding Regulation.
Completes timely medical record reviews on inpatient coded accounts to assess compliance with coding regulations and identifies education opportunities based on reviews.
Monitors the physician query process for appropriate submission and timely response.
Requires the ability to read and effectively analyze a hospital medical record as it relates to clinical documentation and diagnostic/procedural coding of the services provided.
Provides written and verbal reports summarizing audits findings, issues identified and recommendation to leadership, and/or other corporate operations staff as indicated.
Assists in the development and dissemination of auditing processes, policy and procedures regarding compliance related activities.
Effective collaboration with Coding Managers and CDI to create and maintain coding standardization and standard of work across the health system.
Performs coding audits based on referral from CDI and Quality department.
Performs coding audits based on referrals from outside payers and review organizations.
Performs other duties as assigned.
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.
Additional Information:
At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.
Paid Time Off (PTO)
Medical and Prescription Drug Insurance
Dental and Vision Insurance
Retirement Plans
Short & Long Term Disability
Life & Accidental Death Insurance
Tuition Reimbursement
Health Care/Dependent Care Flexible Spending Accounts
Wellness Programs
Voluntary Benefits (e.g., Pet Insurance)
Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!
Choosing RWJBarnabas Health!
RWJBarnabas Health is the premier health care destination providing patient-centered,
high-quality academic medicine in a compassionate and equitable manner, while delivering
a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.
RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.
Equal Opportunity Employer
RWJBarnabas Health is an Equal Opportunity Employer