• Job Description

  Req#: 97350

  
  Job Overview:

  The System Inpatient Audit and Query Manager is responsible for auditing hospital encounters to ensure ongoing quality regarding accurate inpatient coding, abstracting, data entry, discharge disposition, POA indictors and DRG assignment. This position will also oversee the physician query process for appropriate submission.

  Qualifications:

  Required:

  • Must have at least one of the following credentials: RHIA, RHIT, or CCS, with at least 8-10 years of coding experience.
  • Must have three to five years of experience in auditing with demonstrated knowledge of DRGs, documentation requirements and current coding guidelines.
  • Must have extensive knowledge of MS DRGs, APR DRGs, APCs, Official Coding Guidelines, and a broad-based and thorough understanding of ICD-10 CM, PCS coding and CPT/HCPCS systems.
  • Must have in depth knowledge of Coding processes, workflow management and electronic health records.
  • Must be proactive and work independently to prioritize multiple tasks and changes in work assignment to meet established deadlines.
  • Must be able to work in a fast-paced healthcare environment, work well under pressure and have the ability to adapt to a constantly changing environment.

  Essential Functions:

  • Ensures accuracy and integrity of ICD-10-CM Coding and DRG assignment for inpatient accounts for the purpose of maintaining compliance with Federal and State Coding Regulation.
  • Completes timely medical record reviews on inpatient coded accounts to assess compliance with coding regulations and identifies education opportunities based on reviews.
  • Monitors the physician query process for appropriate submission and timely response.
  • Requires the ability to read and effectively analyze a hospital medical record as it relates to clinical documentation and diagnostic/procedural coding of the services provided.
  • Provides written and verbal reports summarizing audits findings, issues identified and recommendation to leadership, and/or other corporate operations staff as indicated.
  • Assists in the development and dissemination of auditing processes, policy and procedures regarding compliance related activities.
  • Effective collaboration with Coding Managers and CDI to create and maintain coding standardization and standard of work across the health system.
  • Performs coding audits based on referral from CDI and Quality department.
  • Performs coding audits based on referrals from outside payers and review organizations.
  • Performs other duties as assigned.

  Other Duties:

  Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

• About the company

  RWJBarnabas Health is a network of independent healthcare providers in New Jersey, based out of West Orange. Members include academic centers, acute care facilities, and research hospitals. The goals of the network include collaboration on educational and research programs.

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