Coding Auditor

This is a fully remote position, open to applicants in Florida, +10 more states.

📋 Description

• Oversee the quality of coded data through continuous reviews and assessments of outpatient or inpatient records.

• Evaluate the accuracy of APC or MS-DRGs and the medical record documentation required for precise coding.

• Collaborate on DRG and CPT denials from commercial payers and compose appeal letters as necessary.

• Ensure adherence to coding compliance by utilizing Coding Clinic, authoritative resources, standardized coding standards, conventions, regulations, corporate compliance guidelines, and reimbursement policies.

• Recognize training requirements and deliver education to team members.

• Facilitate or lead coding huddles while coaching and mentoring staff.

• Conduct focused reviews and quality audits, preparing audit reports for management.

• Support coding leadership in reviewing and addressing internal and external coding audits.

• Collaborate with coding leadership to resolve audit findings as required.

• Monitor and assess coding functions to ensure effective and efficient operations and compliance.

• Review documentation opportunities to clarify confusing, incomplete, or conflicting information and procure additional documentation as necessary.

• Assist patient financial services and clinical documentation improvement team members with coding and billing edit inquiries.

• Act as a clinical coding liaison and analyze documentation issues with medical, clinical, CDI, and other departments.

• Support leadership in coordinating iCare initiatives related to the hospital coding department.

• Aid with DRG and specific CPT payer denials, draft appeals, and document denials/audits in the denial management tool for tracking and reporting.

⛳️ Requirements

• High School Diploma or GED (Required).

• 5-6 years of experience in Acute Care Inpatient (IP) and Outpatient (OP) Coding (Required).

• 2 years of auditing experience in Acute Care IP and OP (Required).

• Current working knowledge of ICD-9, ICD-10, and CPT coding principles, as well as government regulations and protocols.

• Intermediate proficiency in Excel, PowerPoint, and Word.

• Ability to complete tasks accurately and with attention to detail.

• Capacity to adapt to changes in the work environment.

• Exceptional interpersonal skills and a team-oriented mindset.

• Proficient in effective communication in both oral and written forms.

• Certified Coding Specialist (CCS) certification through AHIMA upon hire (Required).

• AHIMA ID or credential number must be provided on the application or resume.

• Preferred: Associate's Degree in Healthcare or a related field.

• Preferred: 1 year of Clinical Documentation Integrity experience.

• Preferred: RHIA, RHIT, CCDS/CDIP, or CPC certification upon hire.

🏝️ Benefits

• Remote work eligibility for candidates residing in FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, or VA.