Coding Auditor

JOB SUMMARY

Conducts coding compliance audits of inpatient and outpatient encounters to validate code assignment. Follows the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology.

JOB REQUIREMENTS

• Minimum Education: Associates degree in relevant field preferred or combination of equivalent of education and experience

• Minimum Work Experience: Five (5) years coding experience including, but not limited to, hospital inpatient and outpatient encounters

• Required Licenses/Certifications: AHIMA and/or AAPC Coding Credential, CCS preferred

• Required Skills, Knowledge, and Abilities:

  • Ability to consistently and accurately audit coding of inpatient and outpatient encounters

  • Ability to create clear and concise audit reports and maintain productivity standards

  • Must successfully pass pre-hire coding assessment

• Knowledge of medical terminology, ICD-10 CM/PCS, EM, and CPT-4 coding guidelines and methodologies

• Knowledge of disease pathophysiology and drug utilization

• Knowledge of MS-DRG classification and reimbursement structures

• Knowledge of APC, OCE, NCCI classification and reimbursement structures

• Must be detail oriented and have the ability to work independently

• Computer knowledge of MS Office

• Must display excellent interpersonal skills

• Ability to demonstrate initiative and discipline in time management and assignment completion

• Ability to work in a virtual setting under minimal supervision

Designated Driver

No OSHA Category 3 - Low Risk