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Medical Coding Auditor- Hospital Outpatient Remote

Location
Chicago, IL

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nnJob DescriptionnnnnnnnnnnnnnnnPractice Informationnn nnNavigant Cymetrix unites the strengths of four category-leading companies to address the complexities of today’s healthcare system.  We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.nnnnnnnnResponsibilitiesnn nnThe Medical Coding Auditor- Hospital Outpatient shall report directly to the Internal Quality Control Coding Director and will be responsible for accessing and reviewing the medical record documentation, coding and abstracting accuracy as performed by the Navigant Cymetrix coding team by utilizing ICD-10 and CPT coding classification systems. Review of patient records will be conducted via facility EMR, scanning technology or other established method. This position will perform any and all related job duties as assigned.nnComputer Literacy.nExcellent verbal and written Communication Skills.nHigh level of productivity.nHIPAA compliant work stations.nAdvanced Coding Skills, ICD-10-CM and CPT.nStrong  knowledge of governmental regulations relating to coding.nAbility to work independently.nStrong working knowledge of  Protected Health Information.nEnsure 5% coding quality review (or percentage stipulated in client contract) of each coder’s work is conducted monthly for those facilities the reviewer is assigned. Coding quality review will be conducted to identify abstracting (to include dc disposition and POA indicators), ICD-9-CM, CPT, modifier, and HCPCS coding errors for codes assigned by the coding team (see quality review policies for review details).nReviewer will run coder productivity reports (where applicable) to ensure review percentages are met per facility contract.nReview coding and abstracting on all patient types assigned to include the following: inpatient, ambulatory surgery, observation, ER, clinic and diagnostics in order to assure 96% coder accuracy (or as stipulated by client contract).nBecome familiar with any facility specific coding guidelines and know where to access on the Navigant Cymetrix portal.nRequired to read all Coding Clinics updates and stay abreast of all new coding guidelines.nEnsure code recommendations are supported with AHA Coding guidelines, Coding Clinics, CPT Assistant and/or other appropriate coding references.nPerform chart reviews and coding recommendation notifications (to ensure appropriate turnaround times) to coding team in a timely manner (same day review conducted).nCommunicates in a professional, non-threatening mentorship manner with the coding team in coding quality recommendation discussions.nFollows review escalation policy when coder/review disagreements occur (see quality.nNotify Coding Manager when coding risk areas and error trends are identified.nAssist Coders in answering coding/abstracting questions resulting from the quality reviews.nReviews monthly and quarterly coder quality reports and performs intensification reviews for Coders who fall below the stipulated accuracy rate as part of the corrective action plan.nMaintain a working knowledge of ICD-10-CM and CPT coding principles, governmental regulations, official coding guidelines, and third party requirements regarding documentation and billing.nAbility to maintain average review productivity standards as follows:  Inpatients 1 chart per/hr, AMB 4.25 charts per/hr, emergency department 6.25 charts per/hr, Pathology 30 charts per/hr.  This excludes outliers.nComplete monthly Quality summary and submit to Coding Manager.nReview and be familiar with the audit plan. nAssist as needed in the review of external coding audit company findings and formulates a response to be used in the defense of the codes assigned.nProvide company support for the creation, maintenance and ongoing operation of an efficient and accurate Quality Improvement Plan that is compliant with Local, State, and Federal Government Regulations.nWork with the Coding Manager to provide on-going coding education resulting from the Quality Reviews.  This will involve direct one-on-one correspondence between the coder and reviewer.nMaintain open lines of communication serving as a liaison for coders.nParticipate in meetings as requested.nReviewer must be able to work independently while maintaining specific productivity standards.nBasic computer skills are needed to handle connection issues, downloads and to review specific programs.nReviewer downtime must be reported immediately to the Coding Manager to ensure adequate work flow.nFacility access system problems should be reported to administrative HIM team, facility IT and Navigant Cymetrix help desk immediately.nReviewers are responsible for checking and responding to Navigant Cymetrix email system at least every two hours during review session AND the client secure email system.nReviewers must maintain their current professional credentials while working for Navigant Cymetrix.nReviewers are responsible for maintaining HIPAA compliant work stations (reference HIPAA work station policy).nReviewers are responsible for maintaining patient privacy at all times (reference company handbook policy compliance section 105).nReviewers are responsible for signing a confidentiality statement.nIt is the responsibility of each reviewer to review and adhere to the coding division policy and procedure manual content.nWorks well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services.nCommunication in emails should be professional at all times (reference e-mail policy).nnnnnnnnnQualificationsnn nnnMust hold one of the following credentials: (RHIT, RHIA, CCS).nMust maintain coding credential while employed by Navigant Cymetrix.nMust have three years of coding or review experience.nAbide by all client policies and procedures.nAbide by all Navigant Cymetrix policies and procedures.nPersonal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service.nnInformation System Requirements:nnComputer and monitors provided by Navigant Cymetrix.nInternet Access with DSL or high speed connectivity.nnnRemote office location that meets HIPAA privacy requirements.nnnnnnnnnMental/Physical Requirementsnn nnnStrong conceptual, as well as quantitative and qualitative analytical skillsnWork as a member of a team as well as be a self-motivator with ability to work independentlynConstantly operates a computer and other office equipment to coordinate worknRegularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit datanGenerally works in an office environmentnnnnnnnnnnEEO/C&B Statementnn nnNavigant Cymetrix is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information or any other basis protected by law, ordinance, or regulation.nNavigant will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.  nnnnnnnnnAbout Navigantnn nn**MEMBERS ONLY**SIGN UP NOW***. (NYSE: NCI) is a specialized, global professional services firm that helps clients take control of their future. Navigant’s professionals apply deep industry knowledge, substantive technical expertise, and an enterprising approach to help clients build, manage and/or protect their business interests. With a focus on markets and clients facing transformational change and significant regulatory or legal pressures, the Firm primarily serves clients in the healthcare, energy and financial services industries.  Across a range of advisory, consulting, outsourcing, and technology/analytics services, Navigant’s practitioners bring sharp insight that pinpoints opportunities and delivers powerful results. More information about Navigant can be found at navigant.com.nnnnnnnnnApply for JobnnnnnnnnnnnnnnJob RequirementsnnnnnnnQualificationsnn nnnMust hold one of the following credentials: (RHIT, RHIA, CCS).nMust maintain coding credential while employed by Navigant Cymetrix.nMust have minimum two-three years of acute care medical coding review experience.nAbide by all client policies and procedures.nAbide by all Navigant Cymetrix policies and procedures.nPersonal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service.nnInformation System Requirements:nnComputer and monitors provided by Navigant Cymetrix.nInternet Access with DSL or high speed connectivity.nnnRemote office location that meets HIPAA privacy requirements.nnnnnnnnnMental/Physical Requirementsnn nnnStrong conceptual, as well as quantitative and qualitative analytical skillsnWork as a member of a team as well as be a self-motivator with ability to work independentlynConstantly operates a computer and other office equipment to coordinate worknRegularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit datanGenerally works in an office environmentnnnnnnnnnnEEO/C&B Statementnn nnNavigant Cymetrix is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information or any other basis protected by law, ordinance, or regulation.nNavigant will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.  nnnnnnnnnAbout Navigantnn nn**MEMBERS ONLY**SIGN UP NOW***. (NYSE: NCI) is a specialized, global professional services firm that helps clients take control of their future. Navigant’s professionals apply deep industry knowledge, substantive technical expertise, and an enterprising approach to help clients build, manage and/or protect their business interests. With a focus on markets and clients facing transformational change and significant regulatory or legal pressures, the Firm primarily serves clients in the healthcare, energy and financial services industries.  Across a range of advisory, consulting, outsourcing, and technology/analytics services, Navigant’s practitioners bring sharp insight that pinpoints opportunities and delivers powerful results. More information about Navigant can be found at navigant.com.nnnnnnnnnApply for Jobn

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