Revenue Cycle Auditor-Educator Coding

Where You’ll Work

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

Job Summary and Responsibilities

As our Revenue Cycle Auditor-Educator Coding you will leverage your expert knowledge of current ICD (diagnostic and procedural) and CPT-4 coding classification systems in this advanced-level position. This pivotal role is responsible for ensuring the highest standards of coding accuracy and compliance across our organization, directly impacting revenue cycle integrity and patient care documentation.

Every day you will be the go-to resource for answering complex coding and billing questions, playing a key role in the onboarding and training of new staff. You will perform critical coding/DRG validation audits and lead the development and deployment of comprehensive coding and CDI (Clinical Documentation Integrity) education programs. Working in conjunction with the coding and CDI leadership team, you will plan and execute system-wide training, conduct internal audits with follow-up education, and facilitate the standardization of best practices. You will also monitor and communicate regulatory coding and billing changes for timely and accurate implementation.

To be successful in this role, you will need a deep understanding of healthcare coding guidelines (ICD-10, CPT-4), DRG validation, and revenue cycle best practices. We are seeking a highly analytical and articulate professional with proven experience in coding education, auditing, and compliance. Your ability to act as a liaison between CDI, physicians, clinical quality, and patient financial services, fostering collaborative relationships, is essential to ensure the utmost accuracy and integrity of the inpatient medical record.

• Compliance & Standards: Ensures coding/CDI practices adhere to compliant and regulatory requirements, upholding ethical standards (AAPC/AHIMA).
• Productivity & Workflow: Monitors work queues/worklists to meet KPIs, productivity, and accuracy standards, and identifies complex issue resolutions.
• Cross-functional Collaboration: Acts as a liaison with various departments (CDI, PFS, Patient Registration, Clinical Staff) to resolve problems and improve workflow.
• Strategic Planning & Leadership: Assists leadership in strategic planning, communicates effectively, delivers presentations, and demonstrates strong leadership.
• Continuous Improvement: Identifies training needs, collaborates on audit results and education, and develops/executes process improvement projects.
• Resource Management & Environment: Assesses tools to prevent errors/denials, promotes a professional/team-oriented environment, and provides remote computer troubleshooting.

Job Requirements

Required 

• Associates Other - Associate’s degree in HIM/related field or Associate’s degree in Nursing, 4-6 years Performing coding CDI audits and education in large multifacility healthcare systems
• Certification from AHIMA (CCS, RHIT, RHIA, CDIP), AAPC (CIC) and/or ACDIS (CCDS) to be maintained
• 4-6 years - Performing coding CDI Audits and creating education sessions in large multifacility healthcare systems