Auditor

Omm IT Solutions

8d • Remote

About The Position

PLEASE NOTE: It is a remote position. Schedule: Full-time. Must have their own equipment to work from. Must have reliable internet and a secure work environment. Must be based in EST or CST hours (cannot recruit from Hawaii, Alaska, or California). JOB SUMMARY: Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems.

Requirements

• High School graduate or equivalent.
• Formal ICD-10-CM, ICD-10-PCS, CPT-4 training.
• Associates or Bachelor’s degree. Education will be considered in lieu of experience.
• Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma hospital or 4 years of experience with coding inpatient hospital medical records.
• 2-3 Years Ambulatory coding experience.
• One of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC)

Responsibilities

• Serves as a clinical coding subject matter expert, and utilizes critical thinking analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.
• Audits ICD-10 diagnostic codes and CPT-4 procedure codes outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations.
• Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature ensure accurate APR-DRG/SOI/ROM and POA assignment.
• Serves in an advisory and educator role for Coding Specialists.
• Serves as communicator between Clinical Documentation Specialists and Coding.
• Researches new surgical procedures and technology.
• Provides training to new employees
• Reports coding quality accuracy rate for each coder
• Monitors productivity rate for each coder
• Conducts specialized focused audits as needed.
• Communicates with various departments within the hospitals regarding coding accuracy.
• Refers any problems to management timely, providing clear details.
• Assist coding specialists in writing appropriate coding queries, works collaboratively with CDI, understand Potentially Preventable Complications (PPC’s)/Maryland Hospital Acquired Conditions (MHAC’s), Prevention Quality Indicators (PQI’s) and their impact and other indicators as needed.
• Complies with AHIMA standards of ethical coding and coding compliance guidelines.
• Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies.
• Performs other duties or projects such as coding corrections as assigned by the manager.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree