Coding Auditor

Responsibilities

• Performs audits and reports on the accuracy of procedure coding, facility E&M coding, ICD-10 coding and billing.
• Reviews insurance payments for reimbursement accuracy, based on correct interpretation of clinical data and application of codes, modifiers and payment rules.
• Reviews and audits institutional coding and billing from multiple departments and entities across the organization.
• Assists in training personnel in correct documentation processes and coding guidelines.
• Oversees on-going projects that are within the scope of this position.

Knowledge / Skills / Abilities

• Extensive knowledge of coding rules as outlined by CMS, AHA AMA.
• Ability to identify areas or items which are not in compliance with the rules, present findings to various groups (e.g. physicians, nurses, administrators/directors coders, billing representatives) and recommend appropriate changes to policies and procedures.
• Ability to meet the American Academy of Procedural Coders and/or AHIMA's continuing education requirements.

Qualifications

• RHIA certification and two years of coding experience in multiple specialties,
• OR RHIT or CPC certification or a Bachelor's degree in a health sciences related area, and four years coding experience in multiple specialties,

Qualifications (Preferred)

• Working Conditions and Physical Demands: Employee must be able to meet the following requirements with or without an accommodation. This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. Physical Requirements: Color Determination, Listening, Manual Dexterity, Near Vision, Sitting, Speaking, Standing.