Audit Education Liaison - ED

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Responsible for ensuring the accuracy and completeness of clinical coding that results in appropriate reimbursement and data integrity and validation of the coded information for external and internal sources. Typically reports to Compliance/Auditing Manager

The incumbent will audit to ensure that professional services documentation accurately reflects compliance with published guidance, policies, procedures, coding and reimbursement rules. Monitoring for changes in laws, rules, regulations, and code assignments that impact documentation and reimbursement is implicit. Identify, document and present any errors, irregularities or findings to physicians, senior management and staff. Serve as a resource/subject matter expert in regards to clinical compliance related issues, billing and coding rules and regulations, and interpret and communicate federal and state guidance/laws.
Job Description
Minimum Qualifications

Education: High school diploma or GED, required; Associates degree in healthcare related field preferred.

Licenses/Certifications: One of the following licenses is required:

Certified Coding Specialist (CCS), or
Certified Professional Coder (CPC), or
Registered Heath Information Technician (RHIT), or
Registered Health Information Administrator (RHIA)
Experience / Knowledge/ Skills:

Three (3) years of hospital or physician coding experience with one year HCC experience, preferred
Minimum one (1) year auditing experience in either hospital or physician auditing with 6 months HCC auditing, preferred.
Extensive knowledge of ICD-10 CM, CPT4, HCPCs and modifiers principles and guidelines
Extensive knowledge of reimbursement systems and regulations and policies pertaining to documentation and coding,
Knowledge of spreadsheet design
Proven team player sensitive to organizational dynamics.
Principal Accountabilities

Conducts regular coding audits and coordinates ongoing monitoring of coding accuracy, providing continuous feedback to coding staff.
Serves as a resource for coding staff on organization-wide coding and documentation standards and guidelines.
Keeps abreast of coding guidelines and reimbursement reporting requirements.
Conducts trend analyses to identify patterns and variations in coding practices.
Follow coding compliance policies, official coding guidelines, regulatory requirements and internal policies and procedures affecting the coding process.
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
Other duties as assigned. Read more