Coding Auditor

OSF HealthCare • Peoria, IL

1d • Remote

About The Position

The Coding Auditor is responsible for performing coding and documentation reviews to ensure the quality and integrity of coding data captured for OSF services. Provides validation of accurate and compliant coding and charging to ensure adherence to established coding guidelines of ICD-10, CPT, governmental and third-party payers; ensuring coding quality standards are achieved and maintained. Responds to external coding audits and DRG billing denials, writing appeals, documenting coding rationale and defends OSF coded data based on provider documentation and coding rule and convention as appropriate. Research coding and/or billing code requirements using encoders and various professional and government publications in order to achieve compliance and optimize reimbursement. Participates in productive coding workflows in order to maintain up to date knowledge of current documentation and coding software toolset.

Requirements

• Associates degree in Health Information Management OR Bachelor’s degree in applicable health related field.
• Must have one of the following certifications: RHIA (Registered Health Information Administrator) RHIT (Registered Health Information Technician) CCS (Certified Coding Specialist) CMA (Certified Medical Office Assistant) CPC (Certified Professional Coder) OR will obtain AHIMA-CCS certification within 12 months of hire.
• 3 years of experience in hospital or professional coding.
• Advanced knowledge of ICD10-CM/PCS and CPT/HCPCS coding guidelines
• Knowledge of medical terminology, anatomy/physiology, disease processes, medical records and hospital procedures.
• Ability to concentrate on a task over a period of time without being distracted
• Basic keyboard and software application skills, including Electronic Medical Record systems.
• Demonstrated ability to communicate effectively via written and verbal means
• Demonstrated excellent professional writing skills.
• Analytical skills necessary in collecting, analyzing, and reporting departmental quality indicators ensuring compliance with regulatory data requirements, establishing coding area goals and assessing outside coding review activities.

Nice To Haves

• Fluency with advanced understanding of both MS and APR DRG methodologies.
• Direct experience with chart quality audits and/or denial response writing.

Responsibilities

• Perform coding and documentation reviews to ensure the quality and integrity of coding data captured for OSF services.
• Validate accurate and compliant coding and charging to ensure adherence to established coding guidelines of ICD-10, CPT, governmental and third-party payers.
• Ensure coding quality standards are achieved and maintained.
• Respond to external coding audits and DRG billing denials, writing appeals, documenting coding rationale and defending OSF coded data based on provider documentation and coding rule and convention as appropriate.
• Research coding and/or billing code requirements using encoders and various professional and government publications in order to achieve compliance and optimize reimbursement.
• Participate in productive coding workflows in order to maintain up to date knowledge of current documentation and coding software toolset.

Benefits

• Comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career.

What This Job Offers

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