Coding Auditor

About the role

Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines and implements coding changes.

Responsibilities

• Demonstrates comprehensive knowledge of coding guidelines and principles; performs coding audits for optimization.
• Demonstrates effective skills in validation; provides ad-hoc education to the coding staff.
• Communicates effectively with coders and CDI staff.
• Demonstrates knowledge of coding policy and procedures.
• Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies.
• Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing.
• Reviews potential reassignments; demonstrates accurate and timely review of all reassignments.
• Implements coding changes; demonstrates ability to relate coding changes accurately and efficiently to staff.
• Operates under general guidance; work assignments are varied and require interpretation and independent decisions on course of action.
• Understands department, division, corporate strategy and operating objectives, including impacts.
• Normally receives general instructions on routine work, detailed instructions on new projects or assignments.
• Majority of contact is within own function, area, or department and may be customer service oriented.
• Performs related duties as required.

Qualifications

• Bachelor’s Degree required, or equivalent combination of education and related experience.
• Current Coding credential: Cert Professional Coder – CPC or CCS required.
• 1–3 years of relevant experience required.
• Experience with edits and denials a plus.