External Auditor In/Outpatient
About The Position
Under general supervision of client, Omega’s External Auditor In/Outpatient will perform reviews of inpatient and outpatient or Professional Services medical records for coding accuracy and medical record documentation as it impacts the accuracy of ICD-10-CM, ICD-10-PCS codes driving MS-DRG assignment and ICD-10-CM and CPT-4/HCPCS codes driving the APC assignment. The External Auditor In/Outpatient must be able to identify Physician query opportunities, write compliant queries, assess the accuracy of POA, discharge disposition and modifier assignments. External Auditor In/Outpatient performs data collection for quality and statistical purposes and reports the findings to Omega’s clients.
Requirements
- Associate’s Degree or equivalent training acquired through on-the-job experience.
- Must have at least two years of HIM experience, preferably as an Auditor.
- At least one year of auditing experience.
- Minimum of successful completion of an AHIMA approved Coding Certificate Program.
- CCS, CPC, CPC-P, CPC-H, RHIA or RHIT
- Proficient personal computer skills
Nice To Haves
- None.
Responsibilities
- Review inpatient, outpatient, or physician services medical records for accuracy of coding and data quality. Elements to be included in reviews can include: Inpatient/Observation Cases: All diagnosis and procedure assigned ICD-10-CM and ICD- 10 PCS codes, Discharge disposition assigned, Assigned Present on Admission (POA) indicators, APR, SOI, and ROM assignment for inpatient cases. Outpatient Cases (ER, SDS, Ancillary): All diagnosis and procedure assigned ICD-10-CM and ICD-10 PCS codes, All CPT assigned codes, Modifier use and assignment, APC assignment. Professional Services: All diagnosis codes assigned ICD-10 CM, All CPT codes, All E&M Leveling codes.
- Maintain auditing productivity based on Client and Omega agreed upon requirements.
- Complete Quality Review reports timely and submits to Client for review.
- Utilize all available official references to perform reviews: to include but not limited to International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM), the Current Procedural Terminology (CPT-4) Official Coding Guidelines, Coding Clinic, CPT Assistant, CMS guidelines, etc.
- Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.
Benefits
- health coverage
- dental coverage
- vision coverage
- voluntary insurance options
- a 401(k) plan with employer match
- professional development opportunities
- paid time off
- holiday pay
- bonus programs
- commissions
- other variable incentive plans
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
