Ambulatory Services Auditor and CDS 2
St. Charles Health SystemAbout the role
In addition, this role is eligible to work remotely from an approved state by St. Charles (please refer to the list). If you do not reside in an approved listed state (or do not plan to relocate to an approved listed state) we request, you do not apply for this particular position.
Approved states by St. Charles: Oregon, Arizona, Arkansas, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Tennessee, Utah, and Wisconsin.
About St. Charles Health System:
St. Charles Health System is a leading healthcare provider in Central Oregon, offering a comprehensive range of services to meet the needs of our community. We are committed to providing high-quality, compassionate care to all patients, regardless of their ability to pay. Our values of compassion, excellence, integrity, teamwork, and stewardship guide our work and shape our culture.
What We Offer:
Competitive Salary
Comprehensive benefits including Medical, Dental, Vision for you and your immediate family
403b with up to 6% match on Retirement Contributions
Generous Earned Time Off
Growth Opportunities within Healthcare
ST. CHARLES HEALTH SYSTEM
JOB DESCRIPTION
TITLE: Ambulatory Services Auditor and CDS II
REPORTS TO POSITION: System Revenue Integrity Director
DEPARTMENT: Revenue Integrity
DATE LAST REVIEWED: May 2023
OUR VISION: Creating America’s healthiest community, together
OUR MISSION: In the spirit of love and compassion, better health, better care, better value
OUR VALUES: Accountability, Caring and Teamwork
DEPARTMENTAL SUMMARY: The Revenue Integrity department provides many services to our multi-hospital and medical group organization focusing on the patient financial experience along the entire continuum of care. Our goal is to deliver a delightful, transparent and seamless experience to our patients and customers that captures and collects the revenue earned by SCHS in a quality, efficient and timely manner.
POSITION OVERVIEW: The Ambulatory Services Auditor and Clinical Documentation Specialist II is responsible for conducting chart reviews of outpatient, inpatient and ambulatory service medical documentation across St. Charles Health System to ensure compliance with ICD-10-CM and CPT-4 coding regulations, rules and guidelines. This position will also provide education, feedback and guidance to multiple parties, as needed. This position does not directly manage any other Caregivers.
ESSENTIAL FUNCTIONS AND DUTIES:
Conduct system-wide pre- visit or post-visit chart reviews of professional services to include both hospital and clinic/office settings of care.
Perform audits on/for the HIM Professional Services Coding team and provide feedback and education as needed to ensure compliance with quality coding standards.
Evaluate medical records to ensure the accuracy of clinical documentation to support the acuity of the patient, risk profiles for HCC capture and recapture, and diagnostic and procedural code integrity in compliance with ICD-10-CM and CPT-4/HCPCs rules and guidelines.
Develop and update procedure manuals to maintain standards for correct coding.
Conduct system-wide education and training on complete documentation and other key concepts for supporting professional fee coding and billing in group setting or on an individual basis.
Assist in setting the direction for and providing coding compliance and education.
Provide technical guidance to physicians and other departmental staff in identifying and resolving issues such as incomplete or missing records, or codes that do not conform to approved coding guidelines or organizational standards.
Recommend process changes and improvements within departmental and operational policies and procedures or system changes to reduce losses or improve efficiency.
Monitor trends and prepare reports on such topics as documentation or coding issues and denied claims, for review by management.
Supports the vision, mission and values of the organization in all respects.
Supports Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.
Provides and maintains a safe environment for caregivers, patients and guests.
Conducts all activities with the highest standards
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