Auditor CodingLocation: Miramar, FloridaAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.SummaryResponsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines.ResponsibilitiesConducts and reports on electronic medical record audits to verify ICD-10CM/PCS, CPT and APC, MSDRG, and APRDRG coding and grouping accuracy. Serves as an expert resource for all coding staff. Assists with developing specific departmental goals, standards, and objectives which directly support the strategic plan and vision of the organization. Works closely with inpatient and outpatient coding managers to analyze and resolve claim denials that are rejected by edits from the Revenue Cycle Department. Reviews and responds to all external coding denial audits using ICD-10CM/PCS, CPT and APC, MSDRG, and APRDRG audits. Performs all other duties as assigned. Coordinates, develops, and implements coder intern education and training. Training will align with AHIMA standards of ethical coding and official coding guidelines. Provides feedback based on audit results and tracks coder intern progression throughout the program. Maintains strict adherence to patient confidentiality according to MHS standards and regulatory requirements. Holds educational sessions for coding specialists, documentation specialists, and physicians. Acts as a liaison for electronic physician query process. Utilizes coding audit results to tailor education to increase coding accuracy. Assists the coding staff to format compliant queries and assesses for compliance with AHIMA query standards. Reports results of coding and query compliance audits to management. Maintains thorough knowledge of ICD-10CM/PCS, and CPT coding principles and guidelines; possesses substantial knowledge of MSDRG, APRDRG, APC, and Enhanced Ambulatory Patient Groups (EAPG) classification systems and query guidelines for compliant provider documentation.CompetenciesACCOUNTABILITY, ACCURACY, CUSTOMER SERVICE, EFFECTIVE COMMUNICATION, HUMAN ANATOMY, MEDICAL CODING, MEDICAL TERMINOLOGY (3), RESPONDING TO CHANGE, STANDARDS OF BEHAVIOREducation and Certification RequirementsAccredited Program: Health Information Management (Required)Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - State of Florida (FL)Working Conditions and Physical RequirementsBending and Stooping = 40%Climbing = 0%Keyboard Entry = 60%Kneeling = 40%Lifting/Carrying Patients 35 Pounds or Greater = 0%Lifting or Carrying 0 - 25 lbs Non-Patient = 40%Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%Lifting or Carrying > 75 lbs Non-Patient = 0%Pushing or Pulling 0 - 25 lbs Non-Patient = 40%Pushing or Pulling 26 - 75 lbs Non-Patient = 0%Pushing or Pulling > 75 lbs Non-Patient = 0%Reaching = 40%Repetitive Movement Foot/Leg = 0%Repetitive Movement Hand/Arm = 60%Running = 0%Sitting = 60%Squatting = 20%Standing = 60%Walking = 60%Audible Speech = 60%Hearing Acuity = 60%Smelling Acuity = 0%Taste Discrimination = 0%Depth Perception = 60%Distinguish Color = 60%Seeing - Far = 60%Seeing - Near = 60%Bio hazardous Waste = 0%Biological Hazards - Respiratory = 0%Biological Hazards - Skin or Ingestion = 0%Blood and/or Bodily Fluids = 0%Communicable Diseases and/or Pathogens = 0%Asbestos = 0%Cytotoxic Chemicals = 0%Dust = 0%Gas/Vapors/Fumes = 0%Hazardous Chemicals = 0%Hazardous Medication = 0%Latex = 0%Computer Monitor = 60%Domestic Animals = 0%Extreme Heat/Cold = 0%Fire Risk = 0%Hazardous Noise = 0%Heating Devices = 0%Hypoxia = 0%Laser/High Intensity Lights = 0%Magnetic Fields = 0%Moving Mechanical Parts = 0%Needles/Sharp Objects = 0%Potential Electric Shock = 60%Potential for Physical Assault = 0%Radiation = 0%Sudden Decompression During Flights = 0%Unprotected Heights = 0%Wet or Slippery Surfaces = 0%