External Auditor In/Outpatient

Omega Healthcare Management Services • Boca Raton, FL

4d • Remote

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

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.

What This Job Offers

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