Coding Acuity Auditor Educator is an advanced level position utilizing ICD-10-CM with a thorough focus on how to appropriately apply the official ICD-10-CM coding guidelines. They must have knowledge of the different models of risk adjustment and understand the financial impact of acuity.
The Acuity Auditor Educator role is highly professional and must be able to communicate at a high level to influence and promote change. The Acuity Auditor Educator prepares, presents and distributes accurate and timely acuity education to providers and operations staff around documentation opportunities and available reporting. Assists with training of new providers and supports ongoing acuity education.
Position supports acuity coding quality and population health and value-based care through post-review audits, data quality monitoring, identification of trends/patterns. The Acuity Auditor Educator effectively communicates improvements and collaborates to influence changes. Assures adherence to Fairview and regulatory coding guidelines to accurately abstract diagnosis codes. Uses quality control techniques to validate collected information. Assists manager with other duties as assigned.
Coding Acuity Auditor Educator will be required to also perform some routine coding functions when dependent on work-flow needs.
Auditing provider documentation to determine improvement opportunities and providing individual feedback based on the opportunities identified.
Performing targeted reviews of best practice alerts based on strategic initiatives or noted deficiencies.
Supporting the development of new best practice alerts in Epic.
Developing and presenting educational opportunities in various settings such as digitally or in-person. The educational opportunities may also have varying sizes of attendance.
Collaborate with clinic leadership to achieve benchmark goals.
Monitoring acuity reporting for target areas and high-risk populations to support a high capture rate.
Serves as a contact person for provider questions regarding acuity coding and documentation.
Reviews payer-initiated diagnosis code audits.
Creates tip sheets and educational tools as requested.
Identifies process improvement opportunities and supports standard workflows.
Maintains a knowledge of provider workflows in diagnosis selection in Epic, including an awareness to IMO.
Query providers for additional documentation according to established procedures and guidelines.
Audit and educate multidisciplinary team members, including providers, as it pertains to risk adjustment models and how those models apply to various specialties.
Supports coder education around acuity and seeks opportunities to increase coder awareness.
Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards.
Actively participates in creating and implementing documentation improvements.
Coordinates with provider leadership to share documentation best practice opportunities.
Performs other responsibilities as needed/assigned.
Organization Expectations, as applicable:
Provide on-going learning to staff regarding coding practices.
Complete projects as assigned.
Share payer specific guidelines to ensure correct coding.
Fulfills all organizational requirements
Completes all required learning relevant to the role
Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.
Fosters a culture of improvement, efficiency and innovative thinking.
Performs other duties as assigned
Respect the confidentiality of all information, including information regarding patients, staff members or Fairview business issues, and share information only with those who need to know per Fairview policy
Analytical Thinking : Ability to identify issues, obtain relevant information, relate and compare date from different sources, and identify alternative solutions.
Attention to Detail : Achieves thoroughness and accuracy when accomplishing a task.
Computer Skills : Basic ability to use a computer and applications that are associated with performing basic work tasks (navigate in Windows, Outlook, Epic EHR, etc.).
Critical Thinking : Gathers and integrates critical information, recognizing and addressing underlying assumptions of others, to arrive at effective solutions; breaks down problems into simple tasks or activities; analyzes relationships among several parts of a situation.
Interpersonal Communication : Builds positive relationships, uses tact in sensitive situations; listens well to various points of view; relates well to others at all levels.
Medical Staff Relations : Builds effective partnerships with medical staff, physicians, fostering open lines of communication and establishing trust.
Problem Solving : Identifies problems; determines accuracy and relevance of information; utilizes appropriate tools and staff resources along with sound judgment to generate and evaluate alternatives, and to make recommendations.
Professionalism : demonstrates behavior consistent with the standards, scope of practice, ethics and characteristics of licensed professiona ls.
Certificate program in coding or associate degree in HIM or a certified coder with more than 3 years of coding experience
May have experience in a variety of specialty coding areas and/or hold multiple credentials
Registered Health Information Administrator (RHIA),
Registered Health Information Technician (RHIT)
Certified Coding Specialist (CCS)
Certified Coding Specialist-Professional (CCS-P)
Certified Professional Coder (CPC)
Certified Outpatient Coder (COC)
Certified Professional Medical Auditor (CPMA)
Other approved certified specialty credential
Associates Degree in HIM
5+ years of coding related experience such as coding, abstracting, APC assignment, Data Quality in coding function type as required by position.
Certified Risk Adjustment Coder (CRC)Must be obtained within 12 months from the hire date
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership with the University of Minnesota, ...Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.