Outpatient Coding Auditor

Signature Performance, Inc.•,

About The Position

The Outpatient Coding Auditor is responsible for quality reviews and audits and coordinates with department managers to ensure coding standards are met in accordance with department and organization policies. The role creates written audit reports with clear findings and recommendations, provides educational feedback to coding staff, identifies documentation issues that affect coding accuracy, and communicates opportunities for documentation improvement. The auditor also guides departmental staff in identifying and resolving coding issues or error trends and provides continuing education on changes to coding and reimbursement systems and weaknesses identified during coding validation reviews. The position requires advanced knowledge of ICD-CM, ICD-10-PCS, CPT-4, and HCPCS, along with practical knowledge of reimbursement systems such as PPS, DRGs, and APC. The auditor must work across multiple client systems and be proficient with Microsoft Office applications. U.S. citizenship or naturalized citizenship is required, and all work must be completed in the continental United States, Alaska, or Hawaii.

Requirements

Completion of a formal coding program.
At least 5 years of progressive experience in professional medical coding or reimbursement.
Currently hold a national auditing credential, or be capable of attaining one within 12 months from the start date.
Working knowledge of ICD-10-CM and ICD-10-PCS, medical terminology, anatomy and physiology, and health record content.
Comprehensive understanding of coding guidelines, Coding Clinics, and appropriate coding references, with the ability to apply these resources to audit findings.
Ability to work in multiple client systems.
Proficiency with Microsoft Office applications.
U.S. citizenship or naturalized citizenship.
All work must be completed in the continental United States, Alaska, or Hawaii.

Nice To Haves

AHIMA or AAPC credentials, such as CCS, RHIT, CIC, or CPC.
AAPC auditing credential (CPMA).
Experience with a Multi-Specialty Outpatient Clinic for facility and professional fee services.
Cerner, EPIC, and 3M 360 Encompass experience.
Academic medical facility and professional services auditing experience.

Responsibilities

Conduct outpatient coding quality reviews and audits.
Coordinate with department managers to ensure standards are met in accordance with department and organization policies.
Create clear, accurate written audit reports with findings and recommendations for coders, auditors, managers, and directors.
Deliver educational feedback to coding staff regarding audit findings.
Identify documentation issues that affect coding accuracy, including missing documentation and missed physician queries.
Communicate opportunities for documentation improvement related to coding issues in verbal discussions and written reports or summaries.
Guide departmental staff in identifying and resolving coding issues and error trends.
Provide continuing education about coding and reimbursement system changes and areas of weakness identified during coding validation reviews.