Coding Auditor - Revenue Integrity - FT 1.0 (80 hrs biweekly) (72448)

Memorial Health System•Reno, OH

7d•Onsite

About The Position

In an environment of continuous quality improvement, the Coding Auditor will assist in the review of medical records documentation to ensure completeness, accuracy, and compliance with applicable federal and state regulations and guidelines. The Coding Auditor will also be responsible for all documentation and coding education that is provided to the coding staff and providers. Exhibits the Standards of Excellence and exercises strict confidentiality at all times.

Requirements

High School Diploma/GED required.
Coding certification ( i.e. CCS, CPC, COC, CIC, RHIT, RHIA) with 4 years coding experience required.
Knowledge of coding guidelines; CPT, ICD-10-CM, ICD-10-PCS, MS-DRG, HCC, APR-DRG and HCPCS assignment.
CCI edits, LMRP, federal and state compliance and/or regulatory guidelines.
Reimbursement methodologies and healthcare information systems.
Computer knowledge (Windows Based), including word processing and spreadsheets.
Must be able to communicate written and orally with professional and technical staff.
Must also possess organizational and time management skills.
Must also be able to train and mentor others.

Nice To Haves

Bachelor’s degree in Health Information Management or related field preferred.
Previous supervisory or management experience preferred.

Responsibilities

Manages quality improvement audits and training of designated coding staff and providers.
Researches, analyzes, and responds to internal and external inquiries regarding compliance, inappropriate coding, denials, and billable services.
Acts as expert coding resource to coders, clinical documentation improvement, providers, and other departments within the hospital or provider clinics.
Provides technical support regarding coding compliance documentation; electronic medical records, regulatory provisions, and third party payer requirements.
Develops and maintains coding related policies, procedures, query development, and training materials in conjunction with management.
Organizes, facilitates, performs, tracks, trends, and reports on internal quality reviews.
Ensures audit (external and internal) recommendations are completed (ie education, coding changes, or rebills).
Ensures strict confidentiality of financial records.
Communicates with the coding management are denial trends, coding or documentation issues, and any pending audits or education.
Remain informed about coding issues to comply with federal regulations and updates the coding team.