Ambulatory Services Auditor and CDS 2 at St. Charles Health System

, Oregon, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Feb, 26

Salary

44.05

Posted On

22 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Chart Reviews, ICD-10-CM Coding, CPT-4 Coding, Auditing, Clinical Documentation, Education, Feedback, Guidance, Medical Records Evaluation, Coding Compliance, Technical Guidance, Process Improvement, Trend Monitoring, Customer Service, Professionalism, Confidentiality

Industry

Hospitals and Health Care

Description

Pay range: $29.37 - $44.05 per hour ($61,089 - $91,624 annually), based on experience. 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 of professionalism and confidentiality. Complies with all applicable laws, regulations, policies and procedures, supporting the organization’s corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings. Delivers customer service and/or patient care in a manner that promotes goodwill, is timely, efficient and accurate. May perform additional duties of similar complexity within the organization, as required or assigned. EDUCATION Required: High school diploma or GED Preferred: Associates degree in Health Information Technology or related field LICENSURE/CERTIFICATION/REGISTRATION Required: RHIA, RHIT, CCS-P, CPC, CPMA, CRC, RN or LPN Preferred: CPMA CRC, RN, LPN EXPERIENCE Required: Minimum of 3-5 years of coding, auditing, or clinical experience required. Physician Evaluation and Management coding experience required. Must meet all competencies of the Ambulatory Auditor and CDS I position prior to promotion. Knowledge of current Medicare regulations, including MPFS, IPPS and OPPS. Preferred: Inpatient, Outpatient, and Ambulatory services coding preferred. PERSONAL PROTECTIVE EQUIPMENT Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely. ADDITIONAL POSITION INFORMATION: PHYSICAL REQUIREMENTS: Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level. Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation. Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing. Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-15 pounds, operation of a motor vehicle. Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level. Exposure to Elemental Factors Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface. Blood-Borne Pathogen (BBP) Exposure Category No Risk for Exposure to BBP . Schedule Weekly Hours: 40 Caregiver Type: Regular Shift: First Shift (United States of America) Is Exempt Position? Yes Job Family: AUDITOR Scheduled Days of the Week: Monday-Friday Shift Start & End Time: Flexible within core working hours St. Charles Health System is a private, nonprofit organization, dedicated to providing high-quality care and the latest in health care technology to the communities it serves. Headquartered in Bend, Ore., St. Charles is an integrated delivery system, with a strong focus on population health, that provides a full range of evidence-based health care services within a 32,000-square-mile area in Central and Eastern Oregon. The health system owns and operates a trauma level II, tertiary referral center in Bend, a trauma level III, type B rural hospital in Redmond, and trauma level IV critical access hospitals in both Prineville and Madras. As the largest employer in Central Oregon, St. Charles Health System and St. Charles Medical Group care for our communities in more than two dozen outpatient clinics and in more than 20 specialty areas of medicine. For additional information, such as Career FAQ's, benefits, and why your dream job awaits, please visit our Careers site. With a variety of nursing positions available, you can choose a career path that fits both your interests AND your lifestyle. Please click on the link for additional help on navigating the candidate site and features of the candidate home page. Candidate Home User Guide

Responsibilities

The Ambulatory Services Auditor and Clinical Documentation Specialist II conducts chart reviews of medical documentation to ensure compliance with coding regulations. This role also provides education and feedback to various parties to maintain coding quality standards.