Inpatient Coding Quality Associate

R1 RCM; Garden City (ID); On-site; USD 60,000 - 80,000; Full time

Job summary

A leading technology provider in healthcare is seeking an Inpatient Coding Quality Associate to ensure coding accuracy and completeness. Responsibilities include reviewing coded cases, identifying errors, and providing coding guidance. The successful candidate will have a minimum of 7 years of inpatient coding experience and an RHIT, RHIA, or CCS credential. This position is based in Idaho and offers competitive compensation and benefits.

Benefits

Competitive benefits package

Opportunities for career development

Qualifications

• Minimum of seven years of hospital inpatient coding experience required.
• In-depth knowledge of medical terminology and human anatomy required.
• Ability to interact effectively with coworkers.

Responsibilities

• Review inpatient coded cases for coding completeness and accuracy.
• Identify potential coding and DRG errors.
• Assist with the training of new auditors.

Skills

Extensive knowledge of ICD-10-CM/PCS

Detail-oriented

Effective communication

Proficient MS Office skills

Education

RHIT, RHIA or CCS credential

Tools

Excel

Job description

Overview

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.

The Inpatient Coding Quality Associate will be responsible for reviewing inpatient coded cases for coding completeness and accuracy. This person will identify potential coding and DRG errors, research appropriate guidelines to support recommended changes, and communicate the changes to the coder involved on a timely basis. The Reviewer provides expert coding advice to coding staff and relays needed coding educational topics to the Regional Manager, IP Coding Quality. This role will report to the Regional Manager of Inpatient Coding Quality. In this role, the successful candidate will maintain required productivity standards and high-quality results.

Here's what you can expect as our Coding Quality Associate:

Responsibilities

• Audits records as defined in the coding quality review plan.
• Review cases flagged by the coding quality software on a daily basis for multiple hospitals, including validating the completeness of documentation, identifying diagnoses and procedures that have been missed, proposing physician queries, and ensuring the accuracy of diagnoses, procedures, POA, discharge disposition and DRG assignment.
• Perform retrospective coding quality reviews as requested. Follow and maintain up-to-date knowledge of industry coding and documentation guidelines (e.g., Official ICD-10 Coding and Billing Guidelines, Coding Clinic advice, R1 and Ascension coding policies and procedures, and AHIMA/ACDIS Query Guidelines) to maintain system-wide coding consistency and remain in compliance with governmental and other regulatory guidelines.
• Communicate audit findings with coders in a timely manner and support the teams in effectively addressing and resolving local coding issues.
• Maintain a high productivity rate and a high accuracy rate in accordance with established auditing standards. Serve as an inpatient coding expert and resource for the coding teams and other departments.
• Work with the Regional Manager to identify areas of educational need based on audit results. Report to, and work with, the Regional Manager to identify improvements in the audit software tool, workflow processes and flag management; assist with evaluation and testing of audit applications and updates as needed.
• Work with the hospital’s CDI team to address and resolve documentation issues. Assist with compilation, generation and analysis of data for results reporting and performance improvement initiatives.
• Contribute to the reduction of the hospital's and Company's coding compliance risks and contribute to the Company’s revenue enhancement goals.
• Maintain an open dialogue and a good working relationship with team members to advance the mission and objectives of the hospitals and R1. Assist with training of new auditors.
• Assist with other audits and duties as requested.

Required Qualifications

• RHIT, RHIA or CCS credential is required.
• A minimum of seven (7) years of hospital inpatient coding experience is required.
• Extensive knowledge of ICD-10-CM/PCS classification system and MS- DRG and APR-DRG methodologies is required.
• In-depth knowledge of medical terminology, human anatomy/physiology, pharmacology, and pathology is required.
• Expert and up-to-date knowledge of industry Official Coding and Reporting Guidelines along with CMS and other agency directives for ICD-10 coding.
• Must have proficient MS Office computer skills, specifically in Excel and knowledge of various coding software/platforms and EMRs.
• Must be detail-oriented and have the ability to work independently and maintain a high productivity rate and coding accuracy rate.
• Ability to interact with other employees through effective communication.
• Must be a self-starter.

Desired Qualifications

• Two (2) years of inpatient coding audit experience is preferred.
• Experience in a large (> 500 beds) hospital or multi-hospital health system is preferred.

For this US-based position, the base pay range is $27.31 - $39.35 per hour. Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.

R1 RCM Inc. (the Company) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices, including recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

To learn more, visit: R1RCM.com

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation and workflow orchestration.

Headquartered near Salt Lake City, Utah, R1 employs over 29,000 people globally.