Vanderbilt University Medical Center Lead Coding Auditor (Inpatient Coding) - Clinical Documentation Auditing in Nashville, Tennessee

Lead Coding Auditor (Inpatient Clinical Documentation)

JOB SUMMARY:

Under direction, responsible for auditing inpatient and outpatient records. Perform analysis to validate medical records and claims. Determine the correct principal diagnosis, identify and assign co-morbidities and complications, major co-morbidities and complications, and secondary diagnoses, and principal and secondary procedures performed in a hospital environment. Apply the Official Guidelines for Coding and Reporting consistently and appropriately for both inpatient and outpatient encounters.

** 80% Working Remote - must be onsite once a week for meetings...

** Must have Coding Inpatient experience

** Must have an active Coding certification

** Must have Coding Auditing experience

KEY RESPONSIBILITIES:

  • Assigns the code that most appropriately reflects documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter.

  • Reviews documentation to ensure assigned codes are supported, recognizes documentation clarification opportunities and works with team to secure additional documentation.

  • Understands how codes are used for reimbursement, public reporting of outcomes, reviewing quality of patient care, financial modeling, strategic planning and marketing.

  • 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 prebill reviews, qualitative reviews and prospective third party payor reviews based on identified issues.

  • Performs data analysis of the audit program. May generate statistical samples for review.

Click Here To View The VUMC Promise of Discovery

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 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. It is a place 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.

VUMC Recent Accomplishments

Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:

VUMC Recent Accomplishments

Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:

  • US News & World Report: #1 Hospital in Tennessee, #1 Health Care Provider in Nashville, #1 Audiology ( Bill Wilkerson Center at http://www.vanderbilthealth.com/billwilkerson/ ), 9 adult and 9 pediatric clinical specialties ranked among the nation's best, #15 Education and Training

  • Truven Health Analytics: among the top 100 hospitals in the US

  • Becker's Hospital Review: one of the "100 Greatest Hospitals in America"

  • The Leapfrog Group: grade "A" in Hospital Safety Score

  • National Institutes of Health: among the top 10 grant awardees for medical research in the US

  • American Association for the Advancement of Science: 12 faculty members elected fellows in 2014

  • Magnet Recognition Program: Vanderbilt nurses are the only group honored in Middle Tennessee

  • Nashville Business Journal: Middle Tennessee's healthiest employer

  • American Hospital Association: among the 100 "Most Wired" medical systems in the US

  • CA

*IND000

*NHCN

High School Diploma or GED (or equivalent experience) and 5 years relevant experience

Licensure, Certification, and/or Registration (LCR)

Must have one of the following coding certifications:

  • Certified Coding Specialist (CCS)

  • Records Health Info Admin (RHIA)

  • Records Health Info Tech (RHIT)

  • Certified Procedural Coder (CPC)

Job Accounting and Finance

Organization: CDACE - Audit 108887

Title: Lead Coding Auditor (Inpatient Coding) - Clinical Documentation Auditing

Location: TN-Nashville-Vanderbilt Hospital (VUH)

Requisition ID: 1810898

Vanderbilt University Medical Center is committed to principles of equal opportunity and affirmative action.