Staff Medical Auditor - Washington DC, United States - MEDSTAR HEALTH Careers

MEDSTAR HEALTH Careers Washington DC, United States

4 weeks ago

Full time

Description

The Clinical Documentation Integrity (CDI) Auditor is responsible for providing expert second level review to ensure the quality and integrity of medical records.

Responsibility includes validating ICD-10-CM/PCS codes by examining medical record documentation of clinical findings, care rendered, and the assignment of present on admission (POA) indicators and discharge disposition status for claims under review.

The auditor works directly with the CDI Manager and Clinical Documentation Specialists (CDS) to streamline processes, identify training needs and ensure consistent information is shared.

Serves as an expert resource for all CDI and coding staff on MS-DRG and APR-DRG payment methodologies as well as coding guidelines and regulatory requirements governing queries.

Exemplifies the mission, vision and values of MedStar Georgetown University Hospital (MGUH)and acts in accordance with MGUH policies and procedures

Evaluates- concurrently and retrospectively- inpatient medical records reviewed by CDS for completeness, accuracy to validate that the clinical documentation supports the assigned ICD-10-CM/PCS codes, the selection of the principal diagnosis and discharge disposition following CMS requirements and Coding Clinic guidance

Conducts second level reviews for MGUH approved CDI/HIM work queues and identifies missed query opportunities on conditions necessitating additional clarification within the medical record.

This includes quality indicators and risk adjustment conditions.
Audits work product and query compliance by CDS staff using a standard tool.

Provides education to CDS based on audit results regarding query compliance, opportunities for diagnosis clarification and accuracy to improve documentation integrity.

Serves as a resource to the CDS staff and ensures adherence to official coding guidelines.

Utilizes data analytics and algorithms to perform prebill or post bill DRG and Clinical Validation reviews to identify revenue integrity issues and opportunities to improve quality metrics.

Assists the CDI manager in educating physicians and other clinicians to facilitate documentation within the medical record to reflect the most accurate severity of illness, expected risk of mortality, hospital acquired conditions, patient safety indicators, and level of service rendered

Assists the CDI manager with developing specific departmental goals and objectives, policies, standards and workflow procedures which directly support the strategic plan for the CDI program and MGUH.

Works with other stakeholders to assist in the development and implementation of training materials related to clinical documentation, ICD-10, quality measures, and other topics as needed.

Reviews and writes appeals for clinical validation external denials, as applicable, and provides feedback to the coding and CDI staff and physician advisors.

Maintain a working knowledge of new coding and DRG guidelines and regulations.
Assists the CDI manager in developing and maintaining reporting tools specific to productivity and quality outcomes.

Assists the CDI Manager with orientation of new CDS staff and in continued professional development of experienced CDS staff.

Acts as an effective liaison between the CDI and coding teams and management as required.
Bachelor's degree B.S. degree in a health care related field required

Excellent knowledge of clinical documentation integrity and coding
Must be able to manipulate and analyze statistical data.
Quality improvement process skills
Proficient in the use of computers to perform daily work including Microsoft Office (Word, Excel, PowerPoint, etc.).
Ability to collect and analyze data related to the CDI program
Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities.

We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.

Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.

MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation.

As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team.

Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities.

We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations.

MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws.

If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.

Ambulatory Medical Coding Auditor

3 weeks ago

Professional Performance Development Group, Inc Bethesda, United States Full time

Location: On-site at Walter Reed National Military Medical Center, Bethesda, MD · Hours: Monday – Friday, 8 working hours between the hours of · Qualifications:Degree/Education: High School diploma or General Educational Development (GED) equivalency · Experience: A minimum of ...
Lead Ambulatory Medical Coding Auditor

3 weeks ago

Professional Performance Development Group, Inc Bethesda, United States Full time

Location: On-site at Walter Reed National Military Medical Center, Bethesda, MD. · Hours: Monday-Friday, 8 working hours between 6:30AM and 6:00PM. · Minimum Qualifications:Degree/Education: Certified through one of the following organizations: American Academy Professional Coder ...
Him/medical Records Clerk

3 weeks ago

Psychiatric Institute of Washington Washington, United States

**Responsibilities**: · PIW is committed to improving the behavioral health care within our community by going beyond the traditional. We will continue to develop diverse and dynamic treatment programs and establish partnerships with others to understand and serve people where th ...
Foreign Service Officer

2 weeks ago

U.S. Agency for International Development Washington, United States

**Duties**: · **As an Auditor (Performance) assigned to the Office of Audits, Inspections, and Evaluations' Millennium Challenge Corporation and Global and Strategic Audits Division, you will**: · - Conduct high quality performance audits in compliance with Generally Accepted Gov ...
Quality Assurance Project Coordinator

2 weeks ago

Washington Metropolitan Area Transit Authority Washington, United States

Job Description**MINIMUM QUALIFICATIONS** · **Education** · - Bachelor's degree in Engineering, Business Administration, Information Systems, Project Management or a related engineering or management field. · - In lieu of a Bachelor's degree, a High School Diploma/GED and four (4 ...
Benefits Coordinator, Full Time

2 weeks ago

Catholic Charities of the Archdiocese of Washington Washington, United States Full time

**ORGANIZATION OVERVIEW**: At Catholic Charities of the Archdiocese of Washington, your knowledge and service in areas such as immigrants and refugees, mental health, social work, employment and adult education, legal and financial services, health care, food assistance, shelter ...
Part Time Night Auditor

2 weeks ago

Residence Inn Washington, United States Part time

City, State: · Washington, District of Columbia · **Part-time Night Auditor, primary shift 11p-7a Friday and Saturday** · The purpose of a NIGHT AUDITOR is to compute, classify, and record numerical data to keep financial records complete. Perform any combination of routine calcu ...
Dha Medical Coding Compliance Specialist

2 weeks ago

Serco North America Washington, United States

Position Description: · Serco is excited to continue our support to the Defense Heath Agency (DHA) Medical Coding Program Branch. The DHA is a joint, integrated Combat Support Agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force to ...
Senior Quality Medical Claims Auditor I

2 weeks ago

Kaiser Permanente Hyattsville, United States

: Job Summary: · Remote from any KP location in CA, OR, CO, WA, GA, MD, VA, HI or D.C. Only. · ** PLEASE NOTE: Salary ranges are geographically based and the posted range reflects the MD region. Salary ranges will vary for other labor markets outside of MD. · Quality Claims Au ...
Production Technician

3 weeks ago

DOT America Columbia City, United States

***:DOT America production technicians are responsible for all aspects of the production process, including: material handling, equipment operation, process monitoring, quality control, warehousing, and various support activities. · **ESSENTIAL DUTIES AND RESPONSIBILITIES**: · - ...
Financial Data Integrity Analyst

3 weeks ago

Watermark Risk Management International Washington, United States

**Come make your mark with Watermark** · ** FOUNDED BY USAF VETERANS** in 2007, we are proud to be a Service-Disabled Veteran Owned Small Business. · ***SUBJECT MATTER EXPERTS** specializing in security and risk management. We're intimately familiar with DOD security programs and ...
Quality Manager

2 weeks ago

Gannett Fleming, Inc. Washington, United States

: · **What You Will Do** · Gannett Fleming's Transit and Rail Business is looking for a** **Quality Manager** to support the development and implementation of quality management strategies with a large public client in the **Washington DC Metro area**. This role will be responsib ...
Vp, Finance

2 weeks ago

Leadership Conference Education Fund Washington, United States

**VP, Finance** · **Who We Are**: · **About the Role**: · We seek a VP, Finance to lead our Finance Department. This position oversees all major financial operations for the organizations, ensuring that resource planning and management activities align with operational and progra ...
Clinical Documentation Integrity

1 week ago

MEDSTAR HEALTH Washington, United States

**General Summary of Position** · The Clinical Documentation Integrity (CDI) Auditor is responsible for providing expert second level review to ensure the quality and integrity of medical records. Responsibility includes validating ICD-10-CM/PCS codes by examining medical record ...
Research Data Coordinator I

2 days ago

Georgetown University Washington, United States

Located in a historic neighborhood in the nation's capital, Georgetown offers rigorous academic programs, a global perspective, exciting ways to take advantage of Washington, D.C., and a commitment to social justice. Our community is a tight knit group of remarkable individuals i ...
Financial Reporting Manager

1 week ago

Danaher Corporation Washington, United States

At first glance, you'll see Danaher's scale. Our 65,000+ associates work across the globe at more than 15 unique operating companies within three platforms—life sciences, diagnostics, and biotechnology. · Look again and you'll see the opportunity to build a meaningful career, be ...
Lead Analyst

1 week ago

FedWriters Washington, United States

**Job Title: Lead Analyst** · **Job Summary**: · This position is in support of the Department of Justice (DOJ). The DOJ requires project management support in carrying out critical tasks related to an audit of the Bureau of Justice Assistance's (BJA's) Prison Rape Elimination Ac ...
Him/medical Records Clerk

1 week ago

Psychiatric Institute of Washington Washington, United States

**Responsibilities**: · **The Psychiatric Institute of Washington **provides comprehensive behavioral healthcare for children, adolescents, adults, and senior adults suffering from mental health and addictive illnesses. PIW is a 130 bed, short-term, acute care hospital offering i ...
Practice Manager

4 days ago

BBD Psychiatry Group, PLLC Washington, United States

BBD Psychiatry Group, PLLC is a small business based in Washington, DC. Our DC clinic, **Eudaimonia**, offers cutting-edge, evidence-based psychiatric services tailored to individuals. We provide telepsychiatry for remote consultations and in-person office visits in the DC Metrop ...
Tier 2 Cyber Incident Response Analyst

1 week ago

Critical Solutions Washington, United States

**Tier 2 Cyber Incident Response Analyst - Shift 1 (M-F 6AM - 2:30PM ET) - (w/ active TS)**: · Washington, DC · Full-time · Clearance Required: Top Secret w/ SCI eligibility · Shift 1: Monday - Friday 6am - 2:30pm EST · **JOB DESCRIPTION** · Critical Solutions is seeking a Tier 2 ...