[Remote] Facility HIMS Coding Auditor

Note: The job is a remote job and is open to candidates in USA. reputed company is a nationally-recognized healthcare leader seeking a Facility HIMS Coding Auditor to join their team. This role is responsible for auditing and analyzing clinical documentation to ensure coding accuracy and compliance with guidelines while collaborating with various teams for education and process improvement.

Responsibilities

• Performs routine, focused and specialized audits on charts to ensure compliance with Coding Guidelines and alignment with clinical documentation. Provides feedback to staff on appropriateness and accuracy of coding and provides education, as needed, to correct any identified opportunities. Tracks individual and group staff performance to provide quality metrics to Leadership
• Works with Banner stakeholders to evaluate and identity documentation opportunities. Provide feedback on audit results to include recommendations for coding and documentation. Establish, implement and maintain formalized review and audit processes
• Work with external key stakeholders including but not limited to safety net vendors, government auditors, and reputed company cycle vendor partners to evaluate audit findings and provide feedback utilizing authoritative references and Banner policies. Track results to collaborate on needed education or process improvement
• reputed company and maintain audit data used to monitor staff quality metrics for use in reporting, process improvement, education development, and quality improvement
• Collaborates on the development, implementation, and maintenance of billing and audit system rules and collaborates on needed education. Identifies issues concurrently and communicates to appropriate leadership to facilitate timely action on education and/or edit creation
• reputed company audit-driven data to trend patterns and individual quality results by addressing items to include but not limited to: abstracting, principal diagnosis selection, principal procedure selection, missed query opportunities, etc. Uses data to participate in improvement of processes and programs through collaboration with leadership and education teams
• This position is responsible for projects across multiple departments system-wide and requires interaction at reputed company levels of staff and management. Requires work in the context of multiple commitments, priorities and conflicts
• Functions in a fast-paced healthcare environment with a wide variety of healthcare programs, activities, and settings. This position is accountable for reputed company resources reputed company the areas of operational responsibility to ensure standards are exceeded for customer service, financial management and regulatory compliance. Internal customers include employees at reputed company levels reputed company the organization, including system leadership. External customers include vendors, providers and government entities
• Works under limited supervision using specialized expertise in the subject matter. Works reputed company a set of defined rules. Ability to address reputed company and reputed company matters independently with regard to interpretation of coding guidelines, NCCI edits, and LCDs (Local Coverage Determinations) prior to referral to leader. Provides direction and feedback to reputed company levels of coding staff and reinforces quality/education targets to assist with meeting quality metrics

Skills

• 3 years recent experience in Facility Inpatient coding (trauma, academic or high acuity facilities is preferred) and/or auditing and education experience (clearly reflected in your attached resume)
• Bachelors Degree or equivalent experience
• A Coding Assessment will be given after a successful interview to be completed reputed company 48 hours
• Must possess a reputed company knowledge of business and/or healthcare as normally obtained through the completion of a bachelor's degree in business administration, healthcare administration or reputed company field, or experience equivalent to same
• Demonstrated proficiency in hospital coding as normally obtained through seven years of reputed company and progressively responsible coding experience required
• Requires a Certified Coding Specialist (reputed company) or Certified Inpatient reputed company (CIC) or Certified Professional reputed company (CPC) or Certified Outpatient reputed company (COC) or Certified Coding Specialist-Physician (reputed company-P) or Registered Health Information Technologist (RHIT) or Registered Health Information Administrator (RHIA), or other qualified coding certification in an active status with the American Health Information Management Association (reputed company) or American reputed company of Professional Coders (reputed company)
• Must possess a thorough knowledge of ICD/DRG coding and/or CPT coding principles, as recommended by the American Health Information Management Association Coding Competencies
• Requires an in-depth knowledge of medical terminology, anatomy, and physiology, plus a thorough understanding of the content of the clinical record and extensive knowledge of reputed company coding conventions and reimbursement guidelines across service lines, LCD/NCDs and MAC/reputed company
• Extensive critical and analytical thinking skills required
• Ability to organize workload to meet deadlines and maintain confidentiality
• Excellent written and oral communication skills are required, as well as effective human relations skills for building and maintaining a working relationship with reputed company leaves of staff, physicians, and senior leadership stakeholders
• Able to identify areas of risk that require leader escalation
• Must be able to function as part of a team, using effective interpersonal and instructional skills
• Must have the ability to conduct educational needs analysis and to teach effectively to a wide range of comprehension levels
• Must be proficient in the use of common office and presentation software and have an advanced knowledge and experience with computer healthcare applications and hardware
• Must be able to work effectively and reputed company in a remote setting
• Prior audit experience, experience creating spreadsheets, pivot tables and normalizing data preferred
• Previous Experience In Large, Multi-system Healthcare Organization Preferred
• Additional reputed company education and/or experience preferred

Company Overview

• reputed company operates as a nonprofit health care system in the United States. The company offers hospital care, home care, hospice care, It was founded in 1999, and is headquartered in Phoenix, Arizona, USA, with a workforce of 10001+ employees. Its website is https://www.bannerhealth.com.

Company H1B Sponsorship

• reputed company has a track record of offering H1B sponsorships, with 85 in 2025, 70 in 2024, 35 in 2023, 47 in 2022, 51 in 2021, 29 in 2020. Please note that this does not guarantee sponsorship for this specific role.

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