HIM Coding Auditing Manager
Quantum Advantage, Inc - Prescott, AZ

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Our community is approximately 2 hours from Phoenix and has earned the reputation as "Everybody's Hometown." Big-city amenities...small-town feeling...history that dates back to Arizona's territorial days...a friendly atmosphere...we offer the sought-after features other communities only dream about. And we're situated in the midst of some of the most spectacular scenery in the mountainous Southwest. We have four definite seasons -- we do get some snow, but of short duration, and the climate is quite mild and dry.

Our full-service hospital is home to an acclaimed cardiac cath lab and angiography service, state-of-the-art imaging services and a full spectrum of healthcare options that range from preventive medicine to family-centered obstetrics. A 24-hour emergency department with Fast Track capabilities, inpatient and outpatient surgical services and a highly respected Partners for Healthy Students program all contribute to important healthcare presence.

We are seeking an experienced HIM Coding/Auditing Sr. Manager. Bachelor's preferred in Healthcare Administration or Health Information. Associate's degree, in Healthcare Administration or Health Information (Bachelor's preferred). Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) credentials; CCS will be considered.

You would be responsible for providing leadership and direction to the Coding Team and to ensure, through auditing, support, evaluation and, programs of education; appropriate coding practices throughout the organization.

  • Provides leadership and direction to the Coding Team.
  • Work one-on-one with coding and billing staff to determine claim errors and to provide information for correcting claims.
  • Works with others to periodically analyze coding data at client to identify coding variations and determine the cause and the appropriateness of such variation and presents such findings to appropriate business leaders.
  • Serve as a resource and liaison in the organization for all coding related topics, issues and questions.
  • Identify patterns, trends and variations in coding or claim data submitted and take appropriate steps in collaborating with the right department to effect resolution or explanation of the variance; performing analysis of coded data to facilitate decision making and to identify risks and gaps.
  • Ensures that members of the coding team perform their job functions competently in a manner consistent with Mission, Vision and Values.
  • Supports all Compliance guidelines ensuring coding compliance.
  • Monitors changes in law, policy and coding standards and advises leadership on the impact of those changes.
  • Conduct daily coding audits and provides medical record reviews and audit reports.
  • Develops and delivers programs and educational content that ensures the coders code in a manner consistent with relevant laws, regulations and standards.
  • Conducts performance evaluations for members of the Coding Department.
  • Assists the organization in reviews relating to internal or external investigations.
Must have following required skills:
  • Excellence in academic achievement with an undergraduate degree, and certified as a coder by the American Health Information Management Association (AHIMA).
  • Minimum five (5) years coding experience with at least three (3) years in a hospital setting.
  • Minimum three (3) years experience in a supervisory capacity of coders in a hospital setting.
  • Specific experience in DRG Validation and/or compliance review in an acute care setting.
  • Expert knowledge of ICD-9, CPT, and APC coding guidelines.
  • Knowledge of compliance and regulatory requirements, and IS and Health Information Systems.
  • Must be able to assess coding and billing workflow and to recommend policies and procedures that optimize the reimbursement process.
  • Must be able to review medical records to determine if the

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About this company
Quantum Advantage provides healthcare recruiting solutions nationwide. Our mission is to meet the long-term career goals for healthcare...