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Senior Auditor CDI and Coding Operations (CCS Preferred)

Location Nottingham, United States
Posted 09-September-2021
Job Summary
Responsibility for independently performing CDI, inpatient and outpatient coding/billing audits and other projects as assigned by the Vice President of Internal Audit (IA) or the Senior Audit Manager, IA. Such work includes, but is not limited to, completing audits for the organization to ensure controls are in place and functioning as intended. This will be accomplished by assessing risks, analyzing controls, and ensuring that business practices are effective, efficient, and compliant with MedStar policies and regulatory requirements.Demonstrates a thorough understanding of complex inpatient and outpatient coding and billing concepts,(including MS-DRGs, ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT, E&M, Modifiers), CDI compliance with REGS.DOC.001- REGS.DOC.004, and auditing concepts; discusses complex coding, CDI, and auditing issues with IA and client management; keeps informed of professional standards and company/department policies and procedures and effectively applies this knowledge to complex client situations. Minimum Qualifications
Bachelor's Degree in Health Information Management or Accounting. Experience
4 years health information management coding experience in an acute care setting;experience with computer systems for encoding and abstracting; auditing experience preferred. License/Certification/Registration
Certified as a RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator), with CCS (Certified Coding Specialist) preferred. Knowledge, Skills & Abilities
Proficient in 3M encoder/grouper, Microsoft Word, Excel and/or Access, PowerPoint. Excellent interpersonal skills, including verbal and written communication. Good public speaking and presentation skills. Experience with data analysis/computer assisted audit techniques (CAAT) and tools and audit management software is a plus. Primary Duties and Responsibilities
Analyzes findings to identify root causes. Communicates ideas appropriately, develops recommendations, and participates in the preparation of audit reports and presentations to management. Contributes to the achievement of established department goals and objectives, and adheres to IA department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations. Embodies and demonstrates the Mission, Vision and Spirit Values of MedStar. Develops audit programs and working papers detailing audit procedures/techniques executed in complex, judgmental and specialized areas of inpatient and outpatient coding and billing and clinical documentation improvement. Obtains adequate audit evidence in accordance with IA department and professional standards. Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate. Performs other duties as assigned. Performs other duties as assigned. Plans and performs audits according to the Annual Internal Audit Plan. Provides innovative and creative ideas to formulate new audit and risk assessment approaches. Stays abreast of general industry, regulatory and economic developments and applies their understanding to identify areas of audit significance, assesses the degree of risk and the nature of the errors that could result from coding and billing errors, identifies unusual or unexpected transactions and processes, and demonstrates a broader understanding by recognizing business trends and emerging technical and industry developments of relevance to share with the client engagement team. Uses Computer-Assisted Audit Techniques (CAAT) as appropriate on projects.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.

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