Coding Audit Coordinator

This is a fully remote position, open to applicants in Louisiana.

📋 Description

• Review documentation and coding of hospital records to ensure adherence to federal and state laws and regulations.

• Assist in the development, execution, and maintenance of a comprehensive clinical coding audit program for both inpatient and outpatient coding.

• Conduct audits and reviews related to coding compliance, charge-based coding, inpatient, and outpatient coding.

• Perform quarterly complex coding quality audits for each coder.

• Review all new staff coding until predetermined quality standards are achieved.

• Audit autocoding clinics for accuracy in documentation and correct assignment of diagnoses.

• Design and implement coding and billing audits for high-risk compliance areas, utilizing RACs, OIG workplans, public profile sites, and other risk indicators.

• Prepare audit reports along with recommendations for enhancements.

• Analyze coding data to identify discrepancies and their underlying causes; present findings to Corporate Coding leadership.

• Provide feedback to coding managers regarding coder performance for annual evaluations.

• Assist with reviews of internal and external investigations.

• Execute code-based charge audits and monitor compliance with government and third-party billing requirements.

• Research and appeal payer payment denials within specified timelines.

• Analyze NCCI edit patterns and support facilities in process improvement initiatives.

• Collaborate with the compliance officer to ensure adherence to coding and billing laws and guidelines.

• Identify opportunities for documentation improvement and process changes.

• Work with coding managers and educators to pinpoint training needs.

• Aid in the creation of coder education programs and deliver training to coders, hospital staff, and physicians on ICD-10-CM/PCS implementation.

• Compile information for Medical Staff, Medical Records, and Quality meetings.

• Act as a resource for Internal Audit staff/RMD concerning coding and chargemaster issues.

• Perform additional duties as assigned.

• Maintain up-to-date coding knowledge and certification through ongoing education, professional journals, and involvement in professional organizations.

⛳️ Requirements

• 5 years of experience in inpatient and outpatient coding.

• Bachelor’s degree with RHIA and CCS; or an Associate's degree with RHIT and CCS.

• If not currently holding a CCS certification, the position is contingent upon obtaining it within 3 months of hire.

• Extensive knowledge of coding practices, including inpatient, outpatient, ambulatory surgery, and ER visits.

• Proficient in ICD-9 and CPT coding.

• Familiarity with the assignment of DRGs, APCs, and official coding guidelines.

• CCS certification is required.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with employer match.

• Continuing education and professional development opportunities.

• Paid time off and flexible scheduling options.