Compliance Coordinator

University of Iowa Health Care is recognized as one of the best hospitals in the United States and is Iowas only comprehensive academic medical center and a regional referral center. Each day more than 12000 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.

University of Iowa Health Care Department of Health Information Management Coding and Abstracting Division is seeking an individual to join our team as a full-time Inpatient Coding Compliance Auditor (Compliance Coordinator) Remote Eligible to perform inpatient coding auditing.

Position Responsibilities:

• Conducts facility external vendor coder and denial coding audits
• Coordinates implements and monitors compliance with coding standards and policies to ensure hospital inpatient cases receive full and accurate reimbursement to comply with coding and payment rules and regulations
• Investigates and responds to audit and denial findings in collaboration with clinical departments compliance patient financial services professional coding department and finance
• Audits monitors and notifies appropriate leadership regarding coding trends potential coding compliance issues and significant audit findings for continued improvement
• Adopts and incorporates initiatives to improve compliance with regulatory requirements and reduce risks to the institution
• Researches develops and implements coding training programs
• Provides direction assignments feedback coaching and counseling related to coding practices to assure outcomes are achieved.

This position is eligible to participate in remote work and applicants who wish to work remotely will be considered. Training will be held eitheron-siteor virtuallyfrom the Hospital Support Services building at a length determined by the supervisor. Remote eligibility will be evaluated upon satisfactory training.Per policy work arrangements will be reviewed annually and must comply with theremote work program and related policiesandemployee travel policy when working at a remote location.

Key Areas of Responsibility

Investigation Remediation and Reporting of Complaints and Reviews

Performs investigation and analysis to ensure accurate coding to comply with coding and compliance policies coding payor and regulatory guidelines. Verifies compliance/non-compliance against established coding and documentation policies procedures applicable laws and regulations. Investigates and responds to coding audit results and denials in collaboration with stakeholders. Investigates potential coding and documentation compliance issues to ensure regulatory compliance. Identifies and resolves trends and errors in reimbursement. Implements recommendations for correction or improvement as appropriate. Reviews and validates coding audit results of non-compliance with escalation to leadership. Advises staff and management regarding claim edits denials and payment trends. Communicates with coding staff third party payors and clinic staff to address and resolve patient account issues. Serves as a resource for complex inpatient coding issues.

Consultation Risk Assessment and Interpretation/Research of Regulations

Responds to coding inquiries where interpretation may be required. Identifies risk areas and gaps with clinical documentation to support coding practice policies and regulations. Identify and recommend education best practices and issues to be audited. Monitors developments in regulations and work with affected areas to develop responses. Conducts research into coding and reimbursement policies guidelines and regulations.

Management of External Standards Review Processes

Designs and implements coding audits. Audits may focus on but are not limited to documentation billing coding medical necessity reimbursement software coding processes and reimbursement. Gathers information for submission creates reports and responds to requests from payors and other external entities. Prepares auditing reports to assure quality and productivity standards are met. Provides developmental and administrative assistance and expertise for data analysis trending and payor coding and billing regulations and policies. Communicates with coders third party payers external vendors and clinical staff and providers to address and resolve complex coding issues.

Policy Development

Provides information regarding coding policies and regulations to inquiries. Recommends coding policy development and compliance. Reviews coding policies and procedures to ensure compliance with legal regulatory accreditation and internal requirements and/or standards/guidelines.

Training and Educational Programs

Makes recommendations based on analysis of audit data and provides education and training to staff when deficiencies are identified or new processes are implemented. Researches develops and implements coding training programs for coding staff physicians/providers department administration and others as needed to ensure appropriate and timely education for compliant coding and billing to increase the skill and expertise of staff and optimize revenue cycle performance. Develops educational coding materials related to all aspects of inpatient coding and documentation. Conducts new staff training re-training and one-on-one training as needed.

Human Resources & Financial Management

Provides functional supervision to coding staff. Provides direction assignments feedback coaching and counseling related to coding practices to assure outcomes are achieved. Advises coding staff regarding claim edits denials and payment trends. Makes recommendations related to the purchase of coding software and educational materials.

As part of performing the key areas of responsibility and competencies described above staff members are expected to meet reasonable standards of work quality and quantity as well as expectations for attendance established by their supervisor. Staff members are also expected to comply with policies governing employee responsibilities and conduct including those contained in theUniversity Operations Manual.

Classification Title: Compliance Coordinator

Department: Health Information Management

University Pay Grade:3B Salary:$55000 to Commensurate

Percent of Time: 100% 40 hours per week

Staff Type: Professional & Scientific

Work Schedule: Monday through Friday hours between 6:00 am and 6:00 pm with or 1-hour unpaid lunch. Additional hours as needed.

Location: Hospital Support Services Building (HSSB) 3281 Ridgeway Drive Coralville IA 52241

BenefitsHighlights:

• salaried position located in Coralville Iowa
• Fringe benefit package including paid vacation; sick leave; health dental life and disability insurance options; and generous employer contributions into retirement plans.

For questions or additional information please contact: Marian Biggins at or

For application questions please contact:

Position and Application Details:

In order to be considered for an interview applicants must upload a resume and cover letter and mark them as a Relevant File to the submission. Job openings are posted for a minimum of 14 calendar days. This job may be removed from posting and filled any time after the minimum posting period has ended.

Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and education/credential verification. Up to 5 professional references will be requested at a later step in the recruitment process.

For questions or additional information please contact Marian Biggins at or

Applicant Resource CenterNeed help submitting an application or accepting an offer Support is available. TheApplicant Resource Centeris now open in the Fountain Lobby at the Main Hospital. Hours: Tuesdays & Thursdays 2:00pm 4:00pm Or by appointment. Contactto schedule a time to visit.