All the benefits and perks you need for you and your family:
· Benefits from Day One
· Career Development
· Whole Person Wellbeing Resources
· Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Job Location: Monday-Friday Remote
The role you’ll contribute:
The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the inpatient or outpatient coding teams across the organization by completing both overall and account-level quality reviews of inpatient and outpatient coding functions. Quality audits are inclusive of assessing staff adherence to inpatient or outpatient coding policies, procedures, and guidelines established by corporate leadership. The Corporate QA is responsible for initial audits during the coder onboarding process for assigned staff, as well as supporting on-going quality assurance needs for coding staff. They will review medical records and documentation for coding accuracy, providing feedback, and delivering additional education to correct inaccurate coding, equipping staff with the knowledge and skills required to achieve industry best practice levels of performance. The Corporate Quality Auditor will adhere to AdventHealth Corporate Compliance standards, as well as rules and regulations of all applicable local, state, and federal agencies and accrediting bodies.
Completes timely and accurate quality assurance audits while adhering to inpatient and/or outpatient coding policies, procedures, and established audit schedule; translates quality auditing results into practical recommendations for improvements in further standardizing audit policies and procedures actionable recommendations for improvement.
The value you’ll bring to the team:
·Uses relevant references to perform audits, including but not limited to: International Classification of Diseases, Clinical Modification (ICD-10-CM and ICD-10-PCS), CPT, ICD-10-CM/PCS Coding Conventions, Official Coding Guidelines, CPT Assistant, AHA Coding Clinic®, CMS guidelines, NCCI guidance, etc.
·Provides outcomes of coding quality audit reviews with leadership
·Maintains current knowledge of coding principles and guidelines as coding conventions are updated; monitors and analyzes current industry trends and issues for potential organizational impact
·Assists with the facilitation of scheduled external audits
·Responds to inpatient or outpatient coding questions from assigned coders/providers and provides official inpatient
·coding references and guidelines.
·Creates clear and accurate audit findings and recommendations in written audit reports that will be used for advising and educating coders, auditors, managers, and directors throughout the organization
·Will provide feedback to coding and CDI team members on escalated accounts.
·Collaborates with providers, AH Clinical, CDI, inpatient and outpatient coding staff to assist with or resolve issues relating to medical record documentation and coding.
·May participate in Iodine Retrospect inpatient reviews in partnership with CDI.
·Provides feedback on the application of coding guidelines, practices, and proper documentation techniques, and data quality improvements.
·Provides input on which quality audit and metrics will be tracked and visualized on shared dashboards to report outcomes and improve processes and workflows including programming requests, process changes, and staff accuracy and efficiencies
·Serves as point person for regional HIM/Coding teams to support quality audits and develop/ maintain reports, scorecards and dashboards that effectively tell the story of the data and highlight education opportunities in a manner that is easily understood and acted upon
·Flags data or analytics limitations, employs critical thinking and creative problem solving to address barriers, and escalates issues to leadership when appropriate
·Documents and presents findings and trends from the quality audits to the HIM/Coding leadership
·Reports any compliance and/or risk issues to the compliance department. Provides suggestions on process improvement.
·Works with the audit team and coding manager to develop meaningful education and may conduct educational huddles for inpatient coders across the organization.
·Makes recommendations to corporate coding leaders for coding policy/guideline changes, based on trending quality issues
·Works with Epic and AIT to identify automation and system enhancements as they pertain to coding.
·Performs other duties as assigned.
Qualifications
The expertise and experiences you’ll need to succeed:
KNOWLEDGE AND SKILLS REQUIRED:
·Thorough understanding of coding processes and workflows
·Expert level knowledge of disease pathophysiology and drug utilization
·Expert level knowledge of Medicare Severity Diagnosis-Related Groups (MS-DRG), and All Patient Refined Diagnosis-Related Groups (APR DRG), NCCI policy, OCE Edits, APCs.
·Expert level knowledge of Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI), and Hierarchical Condition Categories (HCC)
·Expert level knowledge of medical terminology, coding guidelines and methodologies
·Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature (as needed to perform duties)
·Proficient in MS Office (Word, Excel, PowerPoint, Visio, Outlook, etc.) and familiarity with database programs
·Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient manner
·Ability to communicate professionally and effectively in English, both verbally and in written form
·Ability to follow complex instructions and procedures, with close attention to detail
KNOWLEDGE AND EXPERIENCE PREFERRED:
·Epic experience
EDUCATION AND EXPERIENCE REQUIRED:
·Five (5) years of inpatient or outpatient coding or Coding Quality Auditor experience
·Completion of a coding certificate program or associate degree in HIM field
LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:
Certified Coding Specialist
Certified Professional Coder
Certified Professional Coder Payer
Registered Health Information Administrator
Registered Health Information Technician
LICENSURE, CERTIFICATION OR REGISTRATION:
Please be advised that all licenses and certifications listed are not required. If you only have one or some of those listed, you may still be eligible for this position.
• Certified Coding Specialist
• Certified Professional Coder
• Certified Professional Coder Payer
• Registered Health Information Administrator
• Registered Health Information Technician
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.
We’re here to answer your product-related questions
NAHQ wants to partner with you and your organization as you explore how to elevate the profession and advance the discipline of healthcare Quality & Safety.
Need customer service assistance?
For customer service issues, contact us at info@nahq.org or call us at (847) 375-4720. The team is available Monday-Friday from 8 AM-4:30 PM CT.
Important Information for CPHQ Recertification
The recertification process has been streamlined. Unlike previous years, you don’t need to list out your CE activities at the time of completing your application. Instead, you will be asked to attest to having met the requirements, further aligning with the honor-based system of recertification. In the event that your application is randomly selected for audit, you may be required to list your CE activities and submit supporting documentation.
While you may participate in NAHQ learning opportunities (Learning Labs, JHQ articles, etc.), you can only claim CE credit once for each activity. Therefore, if you’ve previously earned CE from a NAHQ learning opportunity, you can’t claim it again, nor will you see the repeat CE appear in your “My Learning� tab. This includes activities used in previous recertification cycles.
Remember, if you’re recertifying during the grace period (1/1/24-1/31/24), you already had to earn your CE hours by Dec 31, 2023.
You still have time! Register today for a multi-day virtual event that addresses the most urgent and important issues facing healthcare today that offers a full schedule of educational sessions organized around NAHQ’s twice-validated healthcare quality competency framework.
We are excited to announce the release of the book “UNSTOPPABLE: Inspiring Stories of Perseverance, Triumph and Joy from Trailblazing Women in Healthcare“.
Be inspired by nine leading healthcare trailblazers, including our own CEO Stephanie Mercado, who empower us all with their vision and passions.
You’ll notice we’ve simplified the application process to recertify. You will not have to list your CE activities at the time of applying*. Simply attest that you met the requirements to complete the application.
*In the event of an audit, CPHQs may need to list activities and upload documentation in their NAHQ account.
Quality Education Resources
Join this informative session, “Quality Education Resources� Thursday, June 22 from 11-11:30 a.m. CT. You will learn about the range of NAHQ quality education resources available to you and hear directly from universities about the benefits they realized from implementing NAHQ’s content within their courses.
Maintain a Pulse on the Latest Quality & Safety Benchmarking Data
Learn more about NAHQ’s enhanced Quality and Safety Benchmarking Program, which provides timely insights to help U.S. hospitals and health systems create data-driven business cases for their quality and safety resourcing.
Understand the Variability Among Your Quality Team Through Workforce Accelerator
Join us Tuesday, May 2, at 11 a.m. CT, to learn more about the different options available to engage with NAHQ’s enterprise-wide solution, Workforce Accelerator®. Options range in size and scope and are designed to meet the various budgetary and timing needs of health systems as they embark on their quality journeys. Register today!
Healthcare Quality and Safety Workforce Report: New Imperatives for Quality and Safety Mean New Imperatives for Workforce Development
The National Association for Healthcare Quality® (NAHQ) has conducted groundbreaking research on the advancement of the quality and safety agenda and has published the results in a new workforce report. NAHQ’s Healthcare Quality and Safety Report answers the question: “Is today’s healthcare workforce doing the work that will advance critical priorities of quality, safety, equity, value, and system sustainability?� The answer is no.
Updated Maintenance Dates: Sunday, February 5, 2023
Maintenance is planned for Sunday, February 5, from 11 p.m.-4 p.m. CT. During this time, you will not have access to the “My Learning” section of your NAHQ account. We apologize for any inconvenience this may cause and thank you for your patience.
NAHQ’s Organizational Membership Subscription will serve as a one-stop shop for healthcare quality and safety training and education. Attend the February 2, at 11 a.m. CT, info session to further understand the new offering that will continue NAHQ’s focus of “Quality in Action.�
NAHQ has published an updated version of the CPHQ exam content outline.
The new exam content will take effect on March 15, 2023. Candidates planning to take the exam before March 15, 2023, can access the current CPHQ exam content outline and related resources on our website.
Missed NAHQ Next? Don’t worry, you can purchase NAHQ Next on-demand and receive access to all content for 60 days from purchase. Benefit from actionable content that addresses issues head-on and features “how-tos” and results. Buy now and have the opportunity to receive 40+ CEs.
Healthcare Quality and Safety Workforce Report: New Imperatives for Quality and Safety Mean New Imperatives for Workforce Development
Member Briefing Workshop and Healthcare Quality Week Webinar
October 7, at 12 p.m. CT
NAHQ will host an exclusive member briefing workshop where NAHQ CEO Stephanie Mercado and NAHQ President-Elect Nidia Williams will review the workforce report in-depth and prepare you to discuss it with your team and leadership during Healthcare Quality Week.
October 17, at 12 p.m. CT
To kick off Healthcare Quality Week, (HQW) NAHQ will host a complimentary webinar with NAHQ leaders to discuss the report, its impact and how you can leverage the report to your advantage.
You still have time! Register today for a multi-day virtual event that addresses the most urgent and important issues facing healthcare today that offers a full schedule of educational sessions organized around NAHQ's twice-validated healthcare quality competency framework.