Hospital Coding Auditor

Job description

The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals.
Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds within 5 working days, if possible. Reviews discharge summaries for coding accuracy. Assists in identification of potential identity errors. Coding Clinics are reviewed and applied appropriately.Assist in other duties as assigned to support the operational needs of the department and organization. May be required to remain on campus immediately before, during, and after severe weather and/or disasters.
Minimum Education
• Technical Diploma/Certificate Coding Required

Minimum Work Experience
• 5 years Inpatient and/or outpatient coding experience Required
• Experience in regulatory issues related to Medicare, and other third party payers as it relates to hospital and ambulatory coding and billing. Required

Licenses and Certifications
• Certified Coding Specialist (CCS_AHIMA) Required or
• Certified Professional Coder (CPC_AAPC) Required or
• Certified Coding Associate (CCA_AHIMA) Required