Remote HIM Inpatient Coding Auditor
Conducts inpatient coding quality audits to validate code assignment is supported by clinical documentation in the medical record. Highly proficient in the proper assignment of ICD-10-CM and PCS codes.
- Performs coding audits of a wide variety of complex inpatient records to validate the ICD-10-CM, PCS codes, MS-DRG and/or APR DRG assignments.
- Provides written, detailed rationale and supporting evidence for recommendations on audit findings.
- Delivers educational feedback to coding staff regarding audit findings.
- Provides guidance to coding staff and management in identifying and resolving coding issues.
- Identifies documentation improvement opportunities that impact coding accuracy.
- Initiates physician queries for clarification of documentation in the medical record to achieve accurate code assignment.
- Collaborates with the clinical documentation improvement team for conflicts between code assignments.
- Reviews and researches billing edits.
- Assists with DRG denials from payers including researching and writing appeal letters.
- Ability to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding compliance.
- Performs other duties as assigned including training/mentoring of new staff and performing research related to special projects
Required Knowledge and Skills
- Comprehensive understanding of coding guidelines, Coding Clinics and appropriate coding references along with the ability to employ these coding resources to audit findings.
- Excellent interpersonal verbal and written communication skills to accurately relay information to internal and external customers.
- Excellent organizational skills with ability to trend and track audit findings effectively.
- Excellent problem-solving skills, the ability to work independently, and to perform under pressure in a teamwork manner with diplomacy and tact.
- Proficient computer and technical skills, along with experience using MS Word, Excel and PowerPoint.
- Ability to meet assigned deadlines.
- Education: Associates degree in Health Information (RHIT), or applicable healthcare field.
- Experience 3-5 years progressive coding experience in acute care hospital setting, including auditing
- Certification/Licensure: AHIMA certification required, such as RHIA, RHIT or CCS
- Software/Hardware: Meditech and 3M 360 experience required
- Other: Expected travel is up to 10%. Education and/or company growth.