Coding Auditor - Revenue Integrity - FT 1.0 (80 hrs biweekly) (72448) at Memorial Health System - Ohio in Reno, OH 45750; Reno, OH 45773

Job description

• Position Type
• Full Time
• Job Shift
• 8-Hour Day Shift
• Category
• Professional
• In an environment of continuous quality improvement, the Coding Auditor will assist in the review of medical records documentation to ensure completeness, accuracy, and compliance with applicable federal and state regulations and guidelines. The Coding Auditor will also be responsible for all documentation and coding education that is provided to the coding staff and providers. Exhibits the Standards of Excellence and exercises strict confidentiality at all times.

Responsibilities

• Manages quality improvement audits and training of designated coding staff and providers.
• Researches, analyzes, and responds to internal and external inquiries regarding compliance, inappropriate coding, denials, and billable services.
• Acts as expert coding resource to coders, clinical documentation improvement, providers, and other departments within the hospital or provider clinics.
• Provides technical support regarding coding compliance documentation; electronic medical records, regulatory provisions, and third party payer requirements.
• Develops and maintains coding related policies, procedures, query development, and training materials in conjunction with management.
• Organizes, facilitates, performs, tracks, trends, and reports on internal quality reviews.
• Ensures audit (external and internal) recommendations are completed (ie education, coding changes, or rebills)
• Ensures strict confidentiality of financial records.
• Communicates with the coding management are denial trends, coding or documentation issues, and any pending audits or education.
• Remain informed about coding issues to comply with federal regulations and updates the coding team.

Requirements

• High School Diploma/GED required.
• Bachelor’s degree in Health Information Management or related field preferred.
• Coding certification (i.e. CCS, CPC, COC, CIC, RHIT, RHIA) with 4 years coding experience required.
• Previous supervisory or management experience preferred.
• Knowledge of coding guidelines; CPT, ICD-10-CM, ICD-10-PCS, MS-DRG, HCC, APR-DRG and HCPCS assignment.
• CCI edits, LMRP, federal and state compliance and/or regulatory guidelines.
• Reimbursement methodologies and healthcare information systems.
• Computer knowledge (Windows Based), including word processing and spreadsheets.
• Must be able to communicate written and orally with professional and technical staff.
• Must also possess organizational and time management skills.
• Must also be able to train and mentor others.

Skills

Required

• Communication
• Organizational skills
• Time management
• Training and mentoring
• CPT
• ICD-10-CM
• ICD-10-PCS
• MS-DRG
• HCC
• APR-DRG
• HCPCS
• CCI edits

Benefits

• Benefits: Memorial Health System is proud to offer an affordable, comprehensive benefit package to all full time and flex time employees. To learn more about the many benefits we offer, please visit our website at www.mhsystem.org/benefits.
• Bonus Eligibility: Available to qualifying full or flex time employees. Eligibility will be determined upon offer.
• Compensation Details: Education, experience, and tenure may be considered along with internal equity when job offers are extended.