The University of Iowa Hospitals & Clinics-recognized as one of the best hospitals in the United States-is Iowa’s only comprehensive academic medical center and a regional referral center. Each day more than 12,000 employees, students, and volunteers work together to provide safe, quality health care and excellent service for our patients. Simply stated, our mission is: Changing Medicine. Changing Lives.®
The University of Iowa Hospitals & Clinics department of Professional Coding Division is seeking a Compliance Coordinator = working title (HCC Risk- Adjustment Coding Auditor) who is responsible for conducting & overseeing chart audits for prospective Medicare Risk Adjustment HCC ICD-10 CM diagnosis(es) codes in advance of patient visits to be appended to the patient medical records in compliance with Federal, State, and Local regulatory, Hospital specific and Payer specific guidelines.
As an HCC Risk Adjustment Medical Coding Auditor for University of Iowa Health Care Clinics and Hospital you will support a culture of Service Excellence by delivering high quality customer service in a fast-paced environment and maintain composure in difficult situations. You must have the skills to provide accurate and comprehensive information (written and verbally) to clinic personnel, physicians, administration, providers, and co-workers in a professional manner. You must demonstrate compassion, empathy and respect to patient rights and confidentiality.
This position is eligible to participate in remote work and applicants who wish to work remotely will be considered. Training will be held either ONSITE or via ZOOM from the HSSB building at a length determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity. Successful candidates must comply with requirements of the remote work program and related policies.
Key Areas of Responsibility:
- Monitor physician and/or facility coding and billing activities performed for the centralized departments with PCD through QA and productivity reviews to ensure compliance with all rules and regulations in a timely manner. Provide education and training when deficiencies are identified, or new processes are implemented.
- Prepare reports to assure quality and productivity expectations are being met.
- Review medical record documentation and assign appropriate ICD-10-CM/PCS, CPT and/or HCPCS codes in accordance with coding/compliance policies, official coding, payor, and regulatory guidelines as needed.
- Incorporate initiatives that improve compliance and reduce risks to the institution.
- Serve as resource and technical expert for complex coding/billing issues.
- Work with staff to suggest additional avenues to resolve coding issues.
- Communicate with coding staff, third party payors, clinic staff and patients to address and resolve patient account issues. Advise staff and management regarding claim edits, denials, and payment trends.
- Provide developmental and administrative assistance and expertise for data analysis, trending, and payer regulations/policies.
- Prepare and distribute reports to summarize the results of department coding activities.
- Implement new processes and targets developed by management.
- Ensure processes for charge capture, charge processing is operating effectively. May make recommendations based on analysis of data.
- Work with HCIS, department administration, finance and others regarding appropriate coding, billing, and medical documentation.
- Assist in planning and implementing various computer applications, software, databases, and bolt on products such as Epic, Computer Assisted Coding, Claims Manager, 3M, etc.
- Gather information for submittal and respond to benchmark surveys or questionnaires required by external agencies. Prepare reports to assure quality and productivity expectations are being met
Classification Title: Coding Coordinator
Working Title: HCC Risk-Adjustment Auditor
Department: Patient Financial Services
Percent of Time: 100%
Staff Type: Professional & Scientific
Pay Grade: 3B
Salary: $55,000 to $75,000
Location: Hospital Support Services Building (HSSB) located in Coralville, IA
Education Requirement:
- Bachelor’s degree or Associates degree preferred or equivalent in education and/or experience.
Required Qualifications:
- 1-3 years’ experience in risk adjustment medical coding or equivalent experience
- CRC certification
- Medical terminology knowledge.
- Basic knowledge and understanding of HIPAA laws and regulations.
- Excellent, effective written and verbal communication skills to achieve and provide quality customer service by always demonstrating positive professional demeanor.
- Demonstrated ability to work with a diverse professional and patient population including the ability to prioritize and coordinate inquiries from patients, staff, and administration.
- Gather the standards and develop complex training content that enhances knowledge of and adherence to internal and external regulations.
- Strong attention to detail with accuracy to achieve or exceed organizational and individual performance goals.
- Demonstrated ability to handle complex and ambiguous situations with minimal supervision.
- Proficiency with standard office computer software applications (i.e., Microsoft Office Suite).
Desirable Qualifications:
- Experience in risk adjustment medical coding or auditing.
- Preferred certifications/licensure: CCS, CEMC, CPC, RHIT, Registered Medical Assistant, or Licensed Practical Nurse
- Knowledge, understanding and/or experience with CMS regulations or industry standards
- Knowledge of anatomy and physiology.
- Completion of ICD-10CM training curriculum.
- Experience and knowledge of medical coding and/or revenue cycle
Application Process:
In order to be considered for an interview, applicants must upload the following documents and mark them as a “Relevant File” for the submission:
- Resume
- (optional) Cover Letter
Job openings are posted for a minimum of 14 calendar days and may be removed from posting and filled any time after the original posting period has ended. Applications will be accepted until 11:59 PM on the date of closing.
Successful candidates will be subject to a criminal background check and credential/education verification. Up to 5 professional references will be requested at a later step in the recruitment process.
For additional questions, please contact Veronica Clark at veronica-clark@uiowa.edu.