University of Iowa Health Care is recognized as one of the best hospitals in the United States and is Iowa's only comprehensive academic medical center and a regional referral center. Each day more than 12,000 employees, students, and volunteers work together to provide safe, quality health care and excellent service for our patients. Simply stated, our mission is: Changing Medicine. Changing Lives.®
University of Iowa Health Care, Department of Health Information Management, Coding and Abstracting Division is seeking an individual to join our team as a full-time Inpatient Coding Compliance Auditor (Compliance Coordinator) - Remote Eligible to perform inpatient coding auditing.
Position Responsibilities:
Conducts facility, external vendor, coder, and denial coding audits,
Coordinates, implements, and monitors compliance with coding standards and policies to ensure hospital inpatient cases receive full and accurate reimbursement to comply with coding and payment rules and regulations,
Investigates and responds to audit and denial findings in collaboration with clinical departments, compliance, patient financial services, professional coding department and finance,
Audits, monitors, and notifies appropriate leadership regarding coding trends, potential coding compliance issues, and significant audit findings for continued improvement,
Adopts and incorporates initiatives to improve compliance with regulatory requirements and reduce risks to the institution,
Researches, develops, and implements coding training programs,
Provides direction, assignments, feedback, coaching, and counseling related to coding practices to assure outcomes are achieved.
This position is eligible to participate in remote work and applicants who wish to work remotely will be considered. Training will be held either on-site or virtually from the Hospital Support Services building at a length determined by the supervisor. Remote eligibility will be evaluated upon satisfactory training. Per policy, work arrangements will be reviewed annually, and must comply with the remote work program and related policies and employee travel policy when working at a remote location.
Key Areas of Responsibility
Investigation, Remediation and Reporting of Complaints and Reviews
Performs investigation and analysis to ensure accurate coding to comply with coding and compliance policies, coding, payor, and regulatory guidelines. Verifies compliance/non-compliance against established coding and documentation policies, procedures, applicable laws, and regulations. Investigates and responds to coding audit results and denials in collaboration with stakeholders. Investigates potential coding and documentation compliance issues to ensure regulatory compliance. Identifies and resolves trends and errors in reimbursement. Implements recommendations for correction or improvement as appropriate. Reviews and validates coding audit results of non-compliance with escalation to leadership. Advises staff and management regarding claim edits, denials, and payment trends. Communicates with coding staff, third party payors, and clinic staff to address and resolve patient account issues. Serves as a resource for complex inpatient coding issues.
Consultation, Risk Assessment, and Interpretation/Research of Regulations
Responds to coding inquiries where interpretation may be required. Identifies risk areas and gaps with clinical documentation to support coding practice, policies, and regulations. Identify and recommend education, best practices, and issues to be audited. Monitors developments in regulations and work with affected areas to develop responses. Conducts research into coding and reimbursement policies, guidelines, and regulations.
Management of External Standards Review Processes
Designs and implements coding audits. Audits may focus on, but are not limited to, documentation, billing, coding, medical necessity, reimbursement software, coding processes and reimbursement. Gathers information for submission, creates reports, and responds to requests from payors and other external entities. Prepares auditing reports to assure quality and productivity standards are met. Provides developmental and administrative assistance and expertise for data analysis, trending and payor coding and billing regulations and policies. Communicates with coders, third party payers, external vendors, and clinical staff and providers to address and resolve complex coding issues.
Policy Development
Provides information regarding coding policies and regulations to inquiries. Recommends coding policy development and compliance. Reviews coding policies and procedures to ensure compliance with legal, regulatory, accreditation, and internal requirements and/or standards/guidelines.
Training and Educational Programs
Makes recommendations based on analysis of audit data and provides education and training to staff when deficiencies are identified, or new processes are implemented. Researches, develops, and implements coding training programs for coding staff, physicians/providers, department administration and others, as needed to ensure appropriate and timely education for compliant coding and billing to increase the skill and expertise of staff and optimize revenue cycle performance. Develops educational coding materials related to all aspects of inpatient coding and documentation. Conducts new staff training, re-training and one-on-one training as needed.
Human Resources & Financial Management
Provides functional supervision to coding staff. Provides direction, assignments, feedback, coaching, and counseling related to coding practices to assure outcomes are achieved. Advises coding staff regarding claim edits, denials, and payment trends. Makes recommendations related to the purchase of coding software and educational materials.
As part of performing the key areas of responsibility and competencies described above, staff members are expected to meet reasonable standards of work quality and quantity, as well as expectations for attendance established by their supervisor. Staff members are also expected to comply with policies governing employee responsibilities and conduct, including those contained in the University Operations Manual.
Classification Title: Compliance Coordinator
Department: Health Information Management
University Pay Grade: 3B https://hr.uiowa.edu/pay/pay-plans/professional-and-scientific-pay-structure-b
Annual Salary: $55,000 to Commensurate
Percent of Time: 100%, 40 hours per week
Staff Type: Professional & Scientific
Work Schedule: Monday through Friday, hours between 6:00 am and 6:00 pm with ½ or 1-hour unpaid lunch. Additional hours as needed.
Location: Hospital Support Services Building (HSSB),3281 Ridgeway Drive, Coralville, IA 52241
Benefits Highlights:
https://hr.uiowa.edu/benefits
Regular salaried position located in Coralville, Iowa
Fringe benefit package including paid vacation; sick leave; health, dental, life and disability insurance options; and generous employer contributions into retirement plans.
For questions or additional information, please contact: Marian Biggins at 319-678-7711 or marian-biggins@uiowa.edu
For application questions, please contact: TA-Support@uiowa.edu
Successful candidates will be subject to a criminal background check. The University of Iowa is an equal opportunity/affirmative action employer. All qualified applicants are encouraged to apply and will receive consideration for employment free from discrimination on the basis of race, creed, color, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, religion, associational preference, status as a qualified individual with a disability, or status as a protected veteran. The University also affirms its commitment to providing equal opportunities and equal access to University facilities. For additional information contact the Office of Equal Opportunity and Diversity, (319) 335-0705.
Position and Application Details:
In order to be considered for an interview, applicants must upload a resume and cover letter and mark them as a "Relevant File" to the submission. Job openings are posted for a minimum of 14 calendar days. This job may be removed from posting and filled any time after the minimum posting period has ended.
Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and education/credential verification. Up to 5 professional references will be requested at a later step in the recruitment process.
For questions or additional information, please contact Marian Biggins at 319-678-7711 or marian-biggins@uiowa.edu
Applicant Resource Center - Need help submitting an application or accepting an offer? Support is available. The Applicant Resource Center is now open in the Fountain Lobby at the Main Hospital. Hours: Tuesdays & Thursdays 2:00pm - 4:00pm, Or by appointment. Contact TAHealthCareSupport@healthcare.uiowa.edu to schedule a time to visit.
Required Qualifications:
Bachelor's degree in Health Information Management or related field, or an equivalent combination of education and experience
3-5 years of experience with ICD-10-CM and ICD-10-PCS coding
3-5 years of experience working with medical records
Knowledge and experience utilizing Epic and 3MTM (or equivalent) MS DRG/APR grouping software
Knowledge, understanding and experience with CMS regulations, standards of The Joint Commission and other accrediting bodies and medical record documentation requirements
Knowledge of medical terminology
Knowledge of anatomy and physiology
Must be proficient in computer software applications (i.e. Microsoft Office Suite)
Excellent professional verbal and written communication skills to provide outstanding customer service and support a "Service Excellence" environment working with a diverse professional and patient population
Requires Health Information Management certification as RHIT or RHIA or coding certification (i.e. CCS) through nationally recognized credentialing body
Desired Qualifications:
5-7 years of experience with ICD-10-CM and ICD-10-PCS coding at an academic medical center
5-7 years of experience working with medical records
Experience with CPT coding
Experience performing coding auditing
Experience performing coding auditing at an academic medical center
6 months to 1 year of supervisory experience
Experience with DRG third party review and appeal process
Knowledge of University policies, procedures, and regulations
Knowledge of coding policies and procedure at University of Iowa Health Care
