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.
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