AdventHealth Corporate
Tampa, FL
Inpatient Hospital Billing Coding Auditor Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS-DRG, APR-DRGs, and overall coding accuracy retrospectively and concurrently. Provides continuing education to individual coders and the coding staff concerning changes in the coding and reimbursement system and any weaknesses identified during the coding validation reviews. Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist, and effectively communicates with physicians and allied health personnel. Assists with writing compelling appeals to all DRG denials from outside agencies, referencing Official Coding Guidelines and Coding Clinic advice as appropriate to defend the DRG assignment and protect the organization's reimbursement. Serves as a resource to other departments in the Revenue Cycle to ensure business continuity and optimal revenue cycle management. Uses critical thinking and sound...