Jackson Health System
Doral, FL
Miami, FL Full-Time Health Information Management
Jackson Health System
Full Time
Summary The HIM Coding Compliance Auditor 1 analyzes abstracted/coded data for the purpose of ensuring accuracy and timeliness as it relates to DNFB management, quarterly AHCA data submissions and PFS communication.
Responsibilities Reviews quality of coded and abstracted data assuring coding compliance within the Jackson Health System.
Performs target and focused MS-DRG, APC, CPT, Case mix and Medical Necessity reviews.
Identifies monitors and corrects rejected claims due to HIM coding.
Works as a liaison with PFS and other internal departments to serve as a communicator/problem-solver for hindrances that prevent reimbursement.
Based on new coding requirements, audit findings, RACs, MACs, etc. prioritizes and supports develops training/education protocols for UHS hospital coders in ICD-9-CM, CPT-4, APCs, Emergency Room Evaluation and Management Coding, Level II coding guidelines, modifier guidelines,...