Inpatient Coding Auditor Compliance Edits

Mishawaka, IN

Top Client in need of Inpatient Coding Auditor Compliance Edits

Hiring Profile:

  • Must Have Skills/Experience: 5 years inpatient coding experience with CCS Required
    • Preferred Skillset/Experience: Associate’s or Bachelor’s Degree in HIM.
  • Inpatient coding educator experience
  • Inpatient Auditor experience
  • Inpatient Coding Manager experience

Required Certifications/Experience:

3 years inpatient coding experience with RHIT/RHIA

5 years inpatient coding experience with CCS

Essential Functions

• Quality Reviews- Hospital Inpatient Evaluates prebill hospital inpatient coding compliance edits to ensure compliance with payer reimbursement methodologies and official coding guidelines. Summarizes quality review results for Coding Managers, Supervisors, Coding Educator, and coding staff; Participates in team meetings with coding personnel when necessary to discuss coding findings. % TIME 50%

• Coding Productivity Meets defined coding productivity standards 10%

• Subject Matter Expert- Coding Serves as the subject matter expert with regards to diagnosis and procedure codes, coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, payer specific guidelines, public reporting of outcomes, quality of patient care outcome measures, and the interpretation of coded data as it relates to revenue cycle compliance. Remains current with coding and industry changes through participation in educational opportunities to maintain credentials. Applies broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability.

• Audit Planning Collaborates with coding leadership in the development and/or implementation of audit/monitoring plans. 10%

• Trend Analysis Provides details specific to audit trends to the Coding Educator for preparation of ongoing education. Notifies coding leadership of trends and topics for education and feedback to coders, physicians, and departments. 10% • Process Improvement Assists with identification and implementation of process improvements according to industry best practice standards to make the best use of resources, decrease costs and improve coding services across the specialized service lines. 5%

• Ethics Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines

  • Max. file size: 300 MB.