October 30
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.
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).
Apply NowOctober 29
501 - 1000
Senior Compliance Auditor ensuring audits meet CMS compliance for Abarca.
October 28
201 - 500
Senior External Claims Auditor at Prospect Medical Systems conducting health plan audits.
October 26
5001 - 10000
Remote Auditor at ReSource Pro conducting virtual audits for insurance companies.