Coding Auditor

JOB SUMMARY

Conducts coding compliance audits of inpatient and outpatient encounters to validate code assignment. Follows the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology.

JOB REQUIREMENTS

Minimum Education

Associates degree in relevant field preferred or combination of equivalent of education and experience

Minimum Work Experience

Five (5) years coding experience including, but not limited to, hospital inpatient and outpatient encounters

Required Licenses/Certifications

AHIMA and/or AAPC Coding Credential, CCS preferred

Required Skills, Knowledge, and Abilities

Ability to consistently and accurately audit coding of inpatient and outpatient encounters

Ability to create clear and concise audit reports and maintain productivity standards

Must successfully pass pre-hire coding assessment

Knowledge of medical terminology, ICD-10 CM/PCS, EM, and CPT-4 coding guidelines and methodologies

Knowledge of disease pathophysiology and drug utilization

Knowledge of MS-DRG classification and reimbursement structures

Knowledge of APC, OCE, NCCI classification and reimbursement structures

Must be detail oriented and have the ability to work independently

Computer knowledge of MS Office

Must display excellent interpersonal skills

Ability to demonstrate initiative and discipline in time management and assignment completion

Ability to work in a virtual setting under minimal supervision

Designated Driver

No

OSHA Category

3 - Low Risk