JOB SUMMARY
The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback to coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.)
ESSENTIAL FUNCTIONS OF THE ROLE
Performs routine coding quality reviews on all coders including third party suppliers as appropriate.
Performs coding quality reviews in collaboration with or for internal customers of the organization.
Provides feedback as appropriate depending on findings.
Abstracts and validates required data elements into the coding and abstracting system.
Works collaboratively with the Clinical Documentation Specialists and Coaches to communicate opportunities for accurate, complete, and compliant documentation.
Completes production coding when needed and assigned by one over.
KEY SUCCESS FACTORS
Strong knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.
Strong knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.
Strong knowledge of anatomy, physiology, and medical terminology.
Demonstrated competency of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.
Strong knowledge of ICD-10-CM/PCS coding and/or CPT procedural coding.
Ability to interpret health record documentation to identify procedures and services for accurate code assignment.
Strong interpersonal verbal and written communication skills.
Skill in the use of computers.
Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables.
Must possess one of the following registration or certifications and 5 years coding experience with at least 1 year of the experience should be as a coding auditor:
Registered Health Information Administrator (RHIA)
Registered Health Information Technologist (RHIT)
Certified Coding Specialist (CCS)
Certified Coding Specialist Physician-based (CCS-P)
Certified Professional Coder (CPC)
Certified Outpatient Coder (COC)
Certified Inpatient Coder (CIC)
Certified Interventional Radiology Cardiovascular Coder (CIRCC)
BENEFITS
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - 5 Years of Experience
- CERTIFICATION/LICENSE/REGISTRATION -
Cert Coding Specialist (CCS), Cert Coding Spec Physician Bas (CCS-P), Cert Inpatient Coder (CIC), Cert Interv Radiology CV Coder (CIRCC), Cert Outpatient Coder (COC), Cert Professional Coder (CPC), Reg Health Info Administrator (RHIA), Reg Health Information Technic (RHIT): Must possess one of the following registration or certifications and 5 years coding experience with at least 1 year of the experience should be as a coding auditor.
