Lead Inpatient Coding Auditor (CCS Coding Cert Preferred) - 100% REMOTE

Discover Vanderbilt University Medical Center:  Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and where your diversity of culture, thinking, learning, and leading is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization:

CDACE - Audit

Job Summary:

JOB SUMMARY
Provides leadership in sharing current and relevant coding subject matter expertise with staff. Performs audits of inpatient and/or outpatient coding. Understands and applies quality standards to all aspects of the documentation integrity program. Identifies areas for strategic audits, coding education and improvement. Supports denials management process and other initiatives.

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INPATIENT CODING EXPERIENCE REQUIRED / Auditor Background Preferred

KEY RESPONSIBILITIES
• Reviews documentation to ensure assigned codes are supported. Recognizes documentation clarification opportunities and works with team to secure additional documentation.
• Assigns codes that most appropriately reflect documentation of the patient stay, severity of illness, risk of mortality, and resources utilized during the patient encounter.
• Writes explanations to support or rebut coding recommendations and appeals for denied or downcoded encounters.
• Participates in accurate data collection, analysis, evaluation, problem solving and recommendations of process improvements.
• Performs pre and post-bill reviews, qualitative review and prospective third party payor reviews based on identified issues. Performs prebill reviews and education for new coders.
• Performs data analysis of the audit program ,findings, and other source data, to identify trends and patterns. Creates detailed reports based on audit findings and facilitates change processes.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.

TECHNICAL CAPABILITIES
• Peer Leadership (Intermediate): The ability to show leadership and influence people of equal rank in an effort to accomplish team goals.
• Medical Coding (Expert): The transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.
• Critical Thinking (Advanced): The objective analysis and evaluation of an issue in order to form a judgment.
• Medical Terminology & Documentation (Expert): The ability to comprehend medical terminology and documentation in an office, or surgical setting.
• Compliance (Advanced): Understanding the rules, regulations, sanctions and other statutory requirements, guidelines and instructions relating to governing bodies and organizations, both internally and externally.
• Written Communication (Advanced): Demonstrates the ability to write clear, detailed, and comprehensive status reports, memos and documentation. Demonstrates an understanding of effective composition, such as having first line in a paragraph state the subject.
• Verbal Communication (Advanced): Ability to enunciate clearly, using appropriate voice control and body language. Effectively transmits technical and business ideas and information to others. Listens carefully to ascertain points being made before trying to be understood.

Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

Core Accountabilities:

Organizational Impact: Delivers projects/assignments that have a direct impact on goals/objectives of the unit/department that the job is in. Problem Solving/ Complexity of work: Conducts extensive analysis of situations or data to resolve numerous, complex issues; may involve the input/work of others. Breadth of Knowledge: Has in-depth lev