Inpatient Medical Coding Auditor
About The Position
The Inpatient Medical Coding Auditor - MSDRG appeals reporting to the Manager reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the appeals team from a variety of medical records. The Disputes Auditor - MSDRG Inpatient Coding consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality. Ensures overall accuracy and compliance of coding appeal reviews by adhering to all appropriate coding guidelines and communicates appeals outcomes to providers in a professional and concise manner. Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices. Manages multiple priorities, collaborates with peers and ensures timely completion of inpatient coding appeals.
Requirements
- RHIA, RHIT, or CCS Certification
- At least 2 years' experience in acute in-patient coding experience and/or MS-DRG auditing
- Recent experience auditing using CMS Manual, LCD, NCD, and Coding Guidelines
- Experience reading and interpreting claims
- Excellent written and verbal communication skills
- Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
- Strong attention to detail
- Can work independently and determine appropriate course of action
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Self-provided internet service with at minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps required; wireless, wired cable or DSL connection suggested.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Nice To Haves
- Associate's Degree or higher in Health Information Management (HIM)
- Experience in Financial Recovery
- Experience in a fast paced, metric driven operational setting
- Experience in APR DRG coding/auditing
Responsibilities
- Reviews the appropriate DRG and ICD-10-CM/ PCS coding assignments for accuracy within the appeals team from a variety of medical records.
- Consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality.
- Ensures overall accuracy and compliance of coding appeal reviews by adhering to all appropriate coding guidelines.
- Communicates appeals outcomes to providers in a professional and concise manner.
- Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices.
- Manages multiple priorities, collaborates with peers and ensures timely completion of inpatient coding appeals.
Benefits
- medical
- dental
- vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
- bonus incentive plan
- bi-weekly payment for internet expense (for employees in California, Illinois, Montana, or South Dakota)
- telephone equipment
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
