Coding Auditor (ICD-10) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas:Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Job Description Position:Coding Auditor (ICD-10)
Duration:Full-Time
Location:Newark/Wall NJ
Job Summary:This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9- CM, ICD-10, DRG assignment payment and auditing.
Responsibilities Identifies and presents billing discrepancies found during audit and coordinates referral of improper claim payments through the appropriate channels.
Identifies error trends as they relate to medical record and or billing documentation or misinterpretation of provider contract stipulations.
Compiles statistics and other audit information to present to accounts, regulatory agencies, and internal requesters.
Reviews and updates audit processes with manager for purposes of keeping up with new innovations in clinical data review and company cost containment initiatives.
Required to train new staff on department/audit procedures.
Performs other special assignments as requested by manager.
Demonstrates knowledge, understanding and conforms to laws, regulations and policies that pertain to the organizational units business.
Knowledge Requires knowledge of medical terminology, detailed knowledge of anatomy & physiology, disease pathogenesis and treatment including procedural drug therapies, ancillary and diagnostic services.
Requires knowledge of principles of utilization management.
Requires knowledge of hospital structures and payment systems.
Requires knowledge of Centers of Medicare and Medicaid prospective payment system regulations.
Prefers knowledge of ACCESS Software.
Qualifications Education Requires a Bachelor's degree in Health Information Management or related field; or a RN with CCS certification.
Experience:Requires a minimum of 3 years of experience in a medical records department of an acute care hospital or other health care facility.
Experience with DRG validation, ICD-9-CM or ICD-10 training and education.
Additional licensing, certifications, registrations:Requires RHIA or RHIT certification; or RN with CCS certification.
Valid Driver's license and access to a car.
Travel (If Applicable) Field position:85 to 90% of time spent in the field at various facilities in NJ, PA & NY
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