Coding Compliance Auditor - Hospital

Shirley Ryan AbilityLab•Chicago, IL

2d•$50,700 - $85,900•Remote

About The Position

The Coding Compliance Auditor - Hospital uses a strong coding background and clinical knowledge to code diagnoses and procedures for admission and discharge claims, helping prevent revenue loss, optimize charge capture, and maintain compliance with applicable standards. The role also supports assigned audits and special projects, which may include training and education. The position is expected to support Shirley Ryan AbilityLab’s vision, mission, and core values, and demonstrate its core attributes while performing job duties. It reports directly to the Director, Medical Records.

Requirements

Coding certification through AHIMA or AAPC for inpatient or outpatient coding, such as RHIA, RHIT, CCS, or CCS-P, and maintenance of continuing education requirements.
Minimum of 2 years of ICD-10 and CPT coding experience and clinical knowledge.
Knowledge of regulatory, billing, and other coding guidelines.
Thorough knowledge of related prospective payment systems.
Auditing skills for coding quality and compliance.
Advanced computer skills and experience with Windows-based applications.
Interpersonal skills to communicate effectively with other departments, physicians, outside agencies, and key customers.
Good writing skills to create reports and ability to graphically present audit data.

Responsibilities

Perform audits required by accrediting organizations to determine whether medical-record information meets established standards and regulations.
Assist the compliance officer with assigned projects from internal or external sources.
Perform assigned Medicaid, Medicare, and other third-party payer audits.
Code inpatient admission and discharge medical records within appropriate timeframes to meet timely billing requirements, and assist with outpatient coding as needed.
Provide coding training and updates for the coding team and other hospital staff as needed.
Send physician queries to support accurate, high-quality documentation in the medical record.
Review charge master updates and additions for appropriate current ICD-10 and CPT code assignment.
Communicate and provide education to medical staff about documentation issues and queries to support accurate coding and billing.
Support continuous quality improvement and perform special projects, training, education, and other duties assigned by the Director of Medical Records.
Perform other duties assigned in the best interest of Shirley Ryan AbilityLab.