Coding Compliance Auditor
Conducts coding compliance audits of inpatient and outpatient encounters to validate code assignment. Follows the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology.
Job Requirements
Minimum Education
Associates degree in relevant field preferred or combination of equivalent of education and experience
Minimum Work Experience
Five (5) years coding experience including; but not limited to; hospital inpatient and outpatient encounters
Required Licenses/Certifications
AHIMA and/or AAPC Coding Credential; CCS preferred
Required Skills; Knowledge; and Abilities
- Ability to consistently and accurately audit coding of inpatient and outpatient encounters
- Ability to create clear and concise audit reports and maintain productivity standards
- Must successfully pass pre-hire coding assessment
- Knowledge of medical terminology; ICD-10 CM/PCS; EM; and CPT-4 coding guidelines and methodologies
- Knowledge of disease pathophysiology and drug utilization
- Knowledge of MS-DRG classification and reimbursement structures
- Knowledge of APC; OCE; NCCI classification and reimbursement structures
- Must be detail oriented and have the ability to work independently
- Computer knowledge of MS Office
- Must display excellent interpersonal skills
- Ability to demonstrate initiative and discipline in time management and assignment completion
- Ability to work in a virtual setting under minimal supervision
Designated Driver
No
OSHA Category
3 - Low Risk