Coding Auditor

Northwell Health

About The Position

Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines; implements coding changes.

Requirements

  • Bachelor's Degree required, or equivalent combination of education and related experience.
  • Current Coding credential: Cert Professional Coder – CPC or CCS required.
  • 1-3 years of relevant experience required.

Nice To Haves

  • Experience with edits and denials a plus.

Responsibilities

  • Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.
  • Demonstrates effective skills in validation; provides ad-hoc education to the coding staff.
  • Able to communicate effectively with coders and CDI staff.
  • Demonstrates knowledge of coding policy and procedures.
  • Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies.
  • Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing.
  • Reviews potential reassignments; demonstrates accurate and timely review of all reassignments.
  • Implements coding changes; demonstrates ability to relate coding changes accurately and efficiently to staff.
  • Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.
  • Work assignments are varied and require interpretation and independent decisions on course of action.
  • Understands department, division, corporate strategy and operating objectives, including impacts.
  • Normally receives general instructions on routine work, detailed instructions on new projects or assignments.
  • Majority of contact is within own function, area, or department and may be customer service oriented.
  • Performs related duties as required.
  • All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act.
  • Duties not mentioned here, but considered related are not essential functions.
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