Coding Compliance Auditor

This is a remote position.

• It is a remote position.
  
• Schedule: Full-time.
  
• Shift hours can be flexible and discussed with the manager. The core business hours are 6.00 AM - 6.00 PM
  
• Must be based in EST or CST hours (cannot recruit from Hawaii, Alaska, or California).
  
• Assessment will be given to qualified candidates identified by client. Assessment will need to be completed and scored before proceeding with interview
  
• Must have their own equipment to work from.
  
• Must have reliable internet and a secure work environment.
  
• Interviews could be web ex or teams.
  
• Temp to hire.
  
• Coversheet is required when submitting candidates
  

• Serves as a clinical coding subject matter expert, and utilizes critical thinking analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.
  
• Audits ICD-10 diagnostic codes and CPT-4 procedure codes outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations.
  
• Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature ensure accurate APR-DRG/SOI/ROM and POA assignment.
  

• Serves in an advisory and educator role for Coding Specialists. Serves as communicator between Clinical Documentation Specialists and Coding. Researches new surgical procedures and technology. Provides training to new employees
  
• Reports coding quality accuracy rate for each coder
  
• Monitors productivity rate for each coder
  
• Conducts specialized focused audits as needed.
  

• Communicates with various departments within the hospitals regarding coding accuracy. Refers any problems to management timely, providing clear details.
  
• Assist coding specialists in writing appropriate coding queries, works collaboratively with CDI, understand Potentially Preventable Complications (PPC’s)/Maryland Hospital Acquired Conditions (MHAC’s), Prevention Quality Indicators (PQI’s) and their impact and other indicators as needed.
  

• Complies with AHIMA standards of ethical coding and coding compliance guidelines.
  

• Demonstrates support and compliance with client mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager.
  

• High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training.
  
• Associates or Bachelor’s degree. Education will be considered in lieu of experience.
  

• Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma hospital or 4 years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience.
  
• Must have inpatient auditing experience
  

• Certified Coding Specialist (CCS)
  
• Registered Health Information Technician (RHIT)
  
• Registered Health Information Administrator (RHIA)
  
• Certified Inpatient Coder (CIC)