Hospital Coding Auditor (IP/OP) – Remote
Location : US
Type : Full-Time
Salary : $19 / Hourly / DOE
This is a full-time position that will be based from your home office, reporting to the Manager, Facility Remote Coding Services within our Reimbursement and Advisory Services. The Coding Auditor ensures that coding compliance initiatives are met for our client. Reviews and analyzes medical records and abstracted data submitted by the clients coding staff to determine the accuracy of payment, code assignment, and adequacy of clinical documentation in accordance with regulatory requirements. This position may lead to permanent employment with the client, depending on performance, and other factors.
The Coding Auditor will have the following responsibilities:
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Ability to successfully perform coding quality reviews to validate correct coding, following the client’s Corporate Coding Compliance Plan and Quality Review guidelines.
Provide feedback to coding staff on audit results.
Provide training on areas where coding compliance is not met.
Maintain ongoing communication with management, coding staff and clients to ensure target coding compliance goals are met.
Perform QA reports.
Claims edit resolution
Other duties as assigned
Skills or Expertise
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Baccalaureate degree in health information management or similar
Associate degree in health information management or similar
RHIT, RHIA and/or CCS required
AHIMA ICD-10-CM/PCS a plus
CPC credential will be considered if candidate is willing to obtain an AHIMA credential within 6 months of hire.
High level coding expertise in IPPS and OPPS.
LCD/NCD full understanding of what they are and ability to research
Ability to research payor policies
Experience in charge reviews " knowledge of chargemaster information in order to understand why something may edit out
Problem solving skills " not just looking at the coding on an account, but ability to see bigger picture to determine what is wrong
Knowledge of EPIC, and computer skills in Microsoft Office products (Word, Excel, PowerPoint, and Access)
Ability to work independently in a fast-paced role
Ability to prioritize, and meet multiple deadlines
Strong communication, administrative and organizational skills
Ability to multi-task and act effectively under pressure with initiative, tact, and poise
Participate in special projects as needed