Position Purpose
The Coding Compliance Specialist is primarily responsible the development, implementation and maintenance of an effective compliance program related to the documentation and coding of medical records within the scope of the Health Information Management Department. The Coding Compliance Specialist will be expected to assist in the development of coding policies and procedures, perform coder audits and to support and provide education for coding and Clinical Documentation Improvement specialist to build an effective compliance structure that will provide guidelines to detect, correct, and prevent coding errors.
What you will do
Annual review and revision of the HIM Coding Compliance Plan
Assist in the development/updates of departmental coding policies and procedures to support the Official Coding Guidelines, Hospital Specific Guidelines, and the Coding Compliance Program
Review and report on regulatory updates including but not limited to, CMS transmittals, local coverage determinations, proposed/final rules and OIG reports/documents in a timely manner
Develop and present annual Coding Compliance Education for all coding staff for both IPPS and OPPS
Support the System Office in assignments for the online coding educational programs
Provide daily pre-bill SMART monitoring for inpatient encounters, and submit monthly reports to Regional Director of HIM Services and Director HIM Revenue Cycle
Coordinate and conduct inpatient and outpatient chart reviews
Minimum Qualifications
Bachelor or Associate’s degree in Health Information Management or equivalent in experience required.
Five years of experience in hospital/facility outpatient and/or inpatient coding required
Previous auditing of ICD coding, and coding compliance experience preferred.
CCS required
CPC or RN in addition to required certification preferred.
Medical terminology, anatomy and physiology, pathophysiology, ICD-10 and CPT coding classification systems, regulatory agency requirements and computer literacy required
Systems include: Epic, 3M 360 CAC, TRACker, Veracity, email and other systems as applicable
Position Highlights and Benefits
Ministry/Facility Information
Saint Francis Hospital is committed to exceeding the expectations of our patients and families by providing world-class service in a progressive, people-centered, compassionate health care environment. We are licensed for 617 beds and 65 bassinets, are a major teaching hospital and the largest Catholic hospital in New England.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.