Riverside Health System

HIMS Coding Auditor (Remote)

Location Name Riverside Health System Peninsula
Job ID


Reports directly to the HIMS Audit Manager and the System Director of Health Information Management Services (HIMS). Responsibilities include working directly with Coding Manager team leads and team members to streamline processes identify training needs and ensure consistent information is shared. Provide training for the coders both inpatient and outpatient to ensure quality and productivity standards are met. Works in conjunction with the appropriate team lead to teach or coordinate coding huddles. This person should have strong coding skills extensive knowledge of medical terminology the human disease process and anatomy & physiology along with a thorough understanding of the workflow and processes utilized by the team members to successfully complete accounts. Serves as a leader and role model for the department and as a member of the Revenue Cycle team by displaying a positive patient-centered and solution-oriented approach and attitude. Viewed as an expert highly sought after resource and a key advisor to other business partners. Sets the example for the department as the expert in accurate thorough and effective work processes. Strong motivation and work ethic. Daily Job Functions include:Ensures coding compliance; applies all coding guidelines and principles as defined in the Coding Clinic and leading authorities. Complies with standardized coding standards and conventions and regulations corporate compliance standards and reimbursement policies. Maintain a working knowledge of new Inpatient and Outpatient coding guidelines. Works in conjunction with coding leadership and team leads to provide coding education to team members and assist with huddles as needed. Perform focused reviews and quality audits as directed by HIMS coding leadership. Prepares audit reports for HIMS leadership.Works with HIMS coding leadership in settlement of audit findings as needed. Assist HIMS coding leadership with reviewing and responding to external and internal coding audits as needed. Monitor and evaluate the coding functions to ensure effective and efficient coding operations and compliance with established standards rules and regulations. Complies with AHIMA standards of ethical coding and coding compliance guidelines along with all third party and government regulations.Serves as a clinical coding liaison and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical staff clinical staff clinical documentation team and other departments as needed. Assists Coding Manager to work on best practices to meet the HIMS coding training needs to include assistance with educating and training of the Health Information Management Coding policies and procedures.Coach and develop team members to achieve team goals that support business strategies and objectives. Responsible for assisting and improving employee performance using audit findings and approved quality processes.Audits for documentation opportunities to clarify confusing incomplete or conflicting information and obtain any needed additional documentation if needed.Assists patient financial services and clinical documentation improvement team members with questions on coding and billing edits.Demonstrates support and compliance with Riverside Health Systems mission vision values statement goals and objectives and policies.Assist leadership and coordination of iCare initiatives related to the hospital coding department.Work under limited supervision organizes and prioritizes assigned work to ensure that work is completed within the assigned time frame.Employee may be required to work on-site in order to collaborate with other team members and clinicians per departmental policy.


Education: High school dipolma required. Associates Degree in healthcare or related field preferred.

Experience: 8 + years of Acute Care Coding (IP and OP) required or 2+ years of IP and OP Acute Care Coding Auditing experience required 2+ years CDI or work with CDI preferred. Knowledgeable in MS Office, encoder (Prefer 3M) and use of EHR (EPIC Preferred).

Certification: Required to have at least one of the following certifications: CCS, RHIA or RHIT (AHIMA/AAPC), CCDS or CDIP (ACDIS/AHIMA). Lean Six Sigma Yellow Belt preferred. Will complete within 1st year.


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