AUDIT INTEGRITY - MEDICAL CODING AUDITOR

About the role

Mountain View Hospital is looking for a Medical Coding Auditor to join our team.

Responsibilities

• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT, ICD-10 and HCPCS coding to these services.
• Contacts physicians through management regarding procedures and other services billed to ensure proper coding.
• Reviews patient logs and other reports of clinical activity to ensure billing is captured for all patients.
• Makes sure all services that can be billed are captured and coded for billing and no charges are incorrectly charged.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the reimbursement staff to answer all inquiries regarding coding and billing for services.
• Works in coordination with the other members of the business office as necessary.
• Maintains and meets the short and long term goals as established for the department.
• Performs duties and job functions in accordance with the policies and procedures established for the department.
• Reports to work, meetings and professional obligations on time.
• Participates in administrative staff meetings and attends other meetings and seminars.
• Assists in evaluating reports, decisions and results of department in relation to established goals.
• Recommends new approaches, policies and procedures to influence continuous improvement in the department's efficiency and services provided.
• Takes ownership of special projects, researches data and follows through with detailed action plans.
• Acts as a problem identifier and resolver, coordinating resolution between the appropriate parties.
• Uses outcomes management computerized information systems to statistically analyze outcomes data including practice patterns.
• Compiles data into reports for the manager or committee including and analysis of trends and patterns.
• Fulfills internal and external requests for outcome data, including developing special reports.
• Participates in presentations to educate staff on outcomes and plans of correction.
• Collaborates with the clinical team to use outcomes data in education.
• Helps train clinicians or other staff on new protocols.

Qualifications

• High School Diploma or GED
• Certified Professional Coding Certificate or Certified Professional Auditing Certificate
• Minimum of 3 years of coding experience
• Working knowledge of CPT, ICD-10-CM, ICD-10-PCS, HCPCS