Coding Auditor

Northwell Health

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About The Position

The Coding Auditor conducts coding audits to optimize diagnosis-related groupings, develops and implements coding instruction classes, prepares coding guidelines, and implements coding changes. The role requires comprehensive knowledge of coding guidelines, policies, and procedures, as well as the ability to validate coding, monitor case mix index, review potential reassignments, and communicate coding changes accurately to staff. The position operates under general guidance, with varied assignments requiring interpretation and independent decisions. It involves understanding department, division, and corporate strategy and operating objectives. Routine work generally receives general instructions, while new projects or assignments receive detailed instructions. Most contact is within the employee’s own function, area, or department and may be customer-service oriented. Performs related duties as required. All listed responsibilities are considered essential functions under the Americans with Disabilities Act; related duties not mentioned are not essential functions.

Requirements

• Bachelor’s degree, or an equivalent combination of education and related experience.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification.
• 1–3 years of relevant experience.
• Comprehensive knowledge of coding guidelines, principles, policies, and procedures.
• Effective validation and communication skills.
• Knowledge of case mix indexing.

Nice To Haves

• Experience with edits and denials.
• Experience in Neurology, Urology, ENT, Orthopedics, or Autoimmune specialties.

Responsibilities

• Conduct coding audits to optimize diagnosis-related groupings.
• Develop and implement coding instruction classes.
• Prepare coding guidelines and implement coding changes.
• Validate coding and provide ad-hoc education to coding staff.
• Communicate effectively with coders and CDI staff.
• Maintain knowledge of current Federal and State coding guidelines and agency literature.
• Monitor and evaluate case mix index.
• Review potential reassignments accurately and in a timely manner.
• Communicate coding changes accurately and efficiently to staff.
• Perform related duties as required.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level