Auditor (Coding/Compliance)

At South Shore Health, we come together to improve the health of our family, friends and neighbors by bringing together people, caregivers and excellence in medicine. We are seeking a Coding and Compliance Auditor to evaluate medical record documentation and coding accuracy, identify opportunities for improvement, and design and deliver coding education and training programs for clinical staff, coders and other key stakeholders. In this role, you will monitor external regulatory and internal process changes and provide support to colleagues in adhering to Federal, State and local requirements. The annual pay range for this role is $73,000.00 - $104,400.00.

Responsibilities:

·        Establish, implement, and maintain a formalized process for coding compliance and a formal review (audit) process, and conduct routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPCs, PCS and ICD-10-CM codes

·        Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection and analyze data to identify deficiencies

·        Develop and monitor follow-up audits and education as determined necessary to improve documentation quality, preparing reports to deliver education specific to training needs identified during audit

·        Plan and develop curriculum in accordance with the organization’s strategic goals, mission and business strategies to improve employee performance leading to quality data and accuracy

·        Design training programs around compliant coding and billing from a regulatory standpoint for any new initiatives or programs affecting the South Shore Health System and revise instructional tools as necessary to ensure Federal/State guidance and training accuracy

·        Assist in the development of follow-up mechanisms to ensure that knowledge and skills learned in training are being applied on the job and have an impact on staff performance in meeting organizational goals

Qualifications:

●       Associate’s or Bachelor’s degree in Health Information Management

●       5+ years of experience in acute care coding with demonstrated expertise in ICD-9-CM, ICD-10-CM, PCS and CPT coding; experience in adult and continuing education, organizational development and training preferred

●       Must be certified in at least one of the following areas: CCA - Certified Coding Associate (AHIMA-American Health Information Management Assoc); CCS - Certified Coding Specialist (AHIMA-American Health Information Management Assoc); CCS-P - Certified Coding Specialist-Physician Based (AHIMA-American Health Information Management Assoc); CPC - Certified Professional Coder (AAPC-American Academy of Professional Coders); CPMA -Certified Professional Medical Auditor (AAPC-Academy of Professional Coders) OR RHIA - Registered Health Information Administrator (AHIMA-American Health Information Management Association)

●       Ability to interact with constituents who have competing priorities and effectively communicate the importance of compliance in a respectful yet authoritative manner

More About South Shore Hospital

South Shore Hospital is Southeastern Massachusetts’s leading provider of emergency, acute and outpatient care. We are consistently recognized for quality of care, including being recognized as a Top General Hospital by the Leapfrog Group. Our hospital has also received Magnet Recognition Program designation, a distinction only 8% of U.S. hospitals achieve. Join us in providing world-class care to the communities of the South Shore.

Living On the South Shore

Located South of Boston, but within easy driving or boating distance of greater New England, the South Shore is a wonderful place to live. No matter your interest: history, the beach, music, art, shopping, fine cuisine, foliage, sports – we have it all. And with some of the best schools in the country, from kindergarten to college, this is a great place to raise a family.

To apply, please visit:

Req# R-22463

careers.southshorehealth.org

EOE