3 drg validation coding auditor jobs found

To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding directives. Ability to communicate...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge...

* Conduct retrospective, concurrent, and prospective audits of medical records to validate the accuracy of ICD-10-CM codes and ensure documentation supports submitted diagnoses for Medicare Risk Adjustment (HCC coding).* Perform detailed internal and external coding audits on a regular basis as defined by compliance & department requirements, including for our nephrology partners.* Execute targeted audit plans, including performing targeted audits of identified HCC outliers.* Identify trends, patterns, and areas of opportunity for documentation and coding improvement through data analysis and audit findings.* Prepare and present formalized audit reports to leadership, summarizing findings, identifying risk areas, and recommending corrective action plans.* Assist in internal and external audits, including Risk Adjustment Data Validation (RADV) audits, by preparing documentation and responding to inquiries.* Perform necessary research to provide supportive regulatory and coding...