Coding Integrity Specialist
CHRISTUS System Office
CORP Revenue Cycle Business-55600
919 Hidden Ridge
Irving, TX 75038
The CHRISTUS Health Coding Integrity Specialist is a system support position that provides acute care coding subject matter expertise, leadership, support, and direction, for the CHRISTUS Health System. The Coding Integrity Specialist will report directly to the Director of Coding Integrity.
The Coding Integrity Specialist will demonstrate high-quality knowledge and understanding of ICD-10-CM, ICD-10-PCS and/or CPT/HCPCS coding guidelines and practices for acute care reimbursement, while maintaining a 95% audit accuracy rate. The Coding Integrity Specialist will have a strong working knowledge of CHRISTUS Health applications in addition to other applicable software, required for auditing.
The Coding Integrity Specialist is responsible for supporting adherence to CHRISTUS standards, policies, procedures, guidelines, official coding guidelines, and other regulatory requirements including Centers for Medicare and Medicaid Services (CMS), the Joint Commission, and HIPAA standards related to HIM. The Coding Integrity Specialist will be responsible for obtaining external guidance as needed from Nosology, AHA, AMA, Z Health, and other recognized sources.
The Coding Integrity Specialist will receive work assignments based on business needs, including but not limited to retrospective reviews, focused reviews, pre-bill reviews, performance improvement reviews, query quality, coding related denials, and clinical documentation improvement opportunities. The Coding Integrity Specialist will audit for key quality metrics, including but not limited to, DRG Accuracy, POA assignment, principal and secondary diagnosis code assignment, procedural coding Accuracy, APC accuracy, modifier usage, discharge disposition, query opportunities, and abstracting accuracy.
The Coding Integrity Specialist will work collaboratively with various CHRISTUS Health teams, including but not limited to, Health Information Management, Coding Operations, Coding Managers, Coding Leads, Coders, Education, Clinical Documentation, Clinical Appeals, PFS, Corporate Compliance, Legal, Regional Leadership, and Revenue Integrity with a focus on Coding Integrity. Coding Integrity Specialists will also work collaborat9ively with external vendors and assist in other areas, as requested by leadership.
The Coding Integrity Specialist will complete coding audits, audit reports, statistical reports, rebuttals, and appeal correspondence in a format and venue that provides professional services and feedback. The Coding Integrity Specialist may assist with education and training for system, regional, or facility healthcare professionals on coding guidelines, practices, proper documentation techniques, medical terminology, and disease process.<h2> POSITION QUALIFICATIONS </h2>
C. Licenses, Registrations, or Certifications