Coding Compliance Auditor
Maryland, MD - USA
Job Summary
This is a remote position.
- It is a remote position.
- Schedule: Full-time.
- Shift hours can be flexible and discussed with the manager. The core business hours are 6.00 AM - 6.00 PM
- Must be based in EST or CST hours (cannot recruit from Hawaii Alaska or California).
- Assessment will be given to qualified candidates identified by client. Assessment will need to be completed and scored before proceeding with interview
- Must have their own equipment to work from.
- Must have reliable internet and a secure work environment.
- Interviews could be web ex or teams.
- Temp to hire.
- Coversheet is required when submitting candidates
- Serves as a clinical coding subject matter expert and utilizes critical thinking analyze and evaluate documentation issues with consultation from the medical and clinical staff and clinical documentation specialists as needed.
- Audits ICD-10 diagnostic codes and CPT-4 procedure codes outpatient ambulatory surgery and observation visits for the purpose of reimbursement research and compliance with federal and state regulations.
- Audits complex inpatient cases such as trauma rehab neurology critical care etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature ensure accurate APR-DRG/SOI/ROM and POA assignment.
- Serves in an advisory and educator role for Coding Specialists. Serves as communicator between Clinical Documentation Specialists and Coding. Researches new surgical procedures and technology. Provides training to new employees
- Reports coding quality accuracy rate for each coder
- Monitors productivity rate for each coder
- Conducts specialized focused audits as needed.
- Communicates with various departments within the hospitals regarding coding accuracy. Refers any problems to management timely providing clear details.
- Assist coding specialists in writing appropriate coding queries works collaboratively with CDI understand Potentially Preventable Complications (PPCs)/Maryland Hospital Acquired Conditions (MHACs) Prevention Quality Indicators (PQIs) and their impact and other indicators as needed.
- Complies with AHIMA standards of ethical coding and coding compliance guidelines.
- Demonstrates support and compliance with client mission vision values statement goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager.
- High School graduate or equivalent. Formal ICD-10-CM ICD-10-PCS CPT-4 training.
- Associates or Bachelors degree. Education will be considered in lieu of experience.
- Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma hospital or 4 years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience.
- Must have inpatient auditing experience
- Certified Coding Specialist (CCS)
- Registered Health Information Technician (RHIT)
- Registered Health Information Administrator (RHIA)
- Certified Inpatient Coder (CIC)
Required Skills:
High School graduate or equivalent. Formal ICD-10-CM ICD-10-PCS CPT-4 training. Associates or Bachelors degree. Education will be considered in lieu of experience. EXPERIENCE: Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma hospital or 4 years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience. Must have inpatient auditing experience CERTIFICATIONS: One of the following: Certified Coding Specialist (CCS) Registered Health Information Technician (RHIT) Registered Health Information Administrator (RHIA) Certified Inpatient Coder (CIC)
Required Education:
High School graduate or equivalent. Formal ICD-10-CM ICD-10-PCS CPT-4 or Bachelors degree. Education will be considered in lieu of experience.