Inpatient and Outpatient Coding Compliance Auditor
The Inpatient and Outpatient Coding Compliance Auditor will provide expert auditing services across various hospitals for Inpatient and all Outpatient services. Review documentation and related coding of inpatient and outpatient services, auditing correct assignment of CPT, ICD - 10 - CM / PCS, HCPCs, to verify coding and billing accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, coding and billing standards. This individual will provide education to coders on audit results, utilize expertise to research and respond to challenging coding questions, develop and provide coding education and evaluate audit results to recommend corrective actions. The individual will have the expertise to respond to client requests to conduct ad hoc coding and billing audits. Primary Responsibilities: Perform coding compliance and quality audits in support of Optum360's Compliance Program and client expectations Analyze and interpret documentation from medical records Clearly document audit findings and calculate billing error rates Provide feedback and education as appropriate depending on findings Articulate audit findings appropriate for audience. Prepare written audit reports as needed summarizing audit findings and any corrective action necessary to mitigate risk Serve as an expert coding resource to client organizations and provide expert coding guidance to other clinical hospital departments Conduct ad hoc coding and billing audits as requested Educate and audit offshore coders and auditors as well as audit and educate new coders Stay abreast of relevant LCDs, NCDs, billing and coding guidelines concerning the current areas of audit focus Research, develop and present education programs to physicians, coders and management as requested Required Qualifications: Bachelors Degree in related concentration such as Health Information Management or Health Information Technology or equivalent experience RHIA or RHIT, CCS 7+ years coding experience 5+ years of audit experience Proficient in application of acute hospital coding guidelines, policies, processes and practices Must maintain active coding credential by obtaining qualifying CEUs as needed Extensive, current knowledge of acute hospital coding rules, official coding guidelines and policies regarding ICD - 10 - CM / PCS, MS - DRG, and CPT / APC Exceptional technical skills in most software applications such as Excel, Word and Outlook Highly experienced and comfortable in most Electronic Medical Records and encoder / grouper products Comfortable and very experienced in leading remote education and training sessions to a group or individuals while using WebEx and other similar applications Preferred Qualifications: Experience with computer assisted coding (CAC) products Pay: $45,000.00 per year To Become A Member: Please visit www.mommyjobsonline.com and click on Join Now and select the Medical Coding WAH Job Bank Registry to become a member to get connected with this client. Please email us your resume after you register with your qualifications and work history. Please reference agent id code MJOLbrittany on your registration submission. Please feel free to consult with us if you have further job related questions about our company at 1-405-418-6160.