JOB SUMMARY
The Coding Auditor 2 is proficient in various types of coding and is responsible for performing coding quality audits, providing feedback to coders and auditors, and providing education via both written and oral presentations. The Coding Auditor 2 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 and/or auditors including third party suppliers as appropriate.
Performs coding quality reviews in collaboration with or for internal customers of the organization.
Participates in training of new Coding Auditors.
Provides education as appropriate depending on findings.
Contributes to Coding Newsletter, Coding Hot Tips.
Reviews, research, and processes billing edits working collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately.
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.
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.
Demonstrated competency with Microsoft Word and PowerPoint.
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/certifications and 2 of the 6 years 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
QUALIFICATIONS
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - 6 Years of Experience
- CERTIFICATION/LICENSE/REGISTRATION -
Must possess one of the following registration/certifications and 2 of the 6 years 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)
