Health Information Management Inpatient Coding Auditor

October 30

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Description

β€’ Responsible for leading coding teams, coder training, work queue management. β€’ Performing prebill and second-level coding reviews utilizing auditing software. β€’ Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues. β€’ Employ critical thinking skills to alert coding leadership to any trends identified in their reviews. β€’ Reviews and responds to inpatient denials as needed. β€’ Conducts review and audit of discharged inpatient records to validate the coding/DRG assignment. β€’ Monitor work queues daily to identify, prioritize and assign accounts. β€’ Mentors and trains coders on application of correct ICD-CD and ICD PCS guidelines. β€’ Coordinates and identifies provider documentation queries for the Clinical Documentation Integrity team. β€’ Maintains working knowledge of CMS regulations and applicable carrier local medical review policies. β€’ Consults and collaborates with clinical documentation specialists on coding practices. β€’ Assists with and develops educational programs for coding staff.

Requirements

β€’ Associate's degree or Coding Certificate through approved American Health Information Management (AHIMA) or other coding certification program. β€’ Four (4) years of experience in in-patient coding and abstracting with healthcare billing process experience in acute care setting. β€’ Required Certifications, Registrations, Licenses: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential. β€’ Knowledge of electronic medical records and 3M or Encoder System. β€’ EPIC health information system experience. Preferred. β€’ Strong knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process. β€’ Knowledge of MS DRG prospective payment system and severity systems. β€’ Knowledge of Clinical Documentation Improvement principles, quality indicators, formal and informal coding audit process. β€’ Ability to work effectively, independently and manage multiple demands consistently. β€’ Proficient computer skills (spreadsheets and database).

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