Coding Quality Auditor

Job description

Job Duties & Responsibilities · Provides internal coding quality reviews to ensure compliance with official coding guidelines for hospital coding · Applies ethical coding principles (CMS, AMA, CPT, ICD-10-CM), HCC coding standards, and revenue cycle knowledge to assess coding accuracy and billing integrity · Reviews and audits post-billed inpatient charts to ensure that the ICD-10 and ICD-10-PCS codes accurately reflect the documentation, patient acuity and level of care provided for the specific admission · Recognizes and reviews patterns with the CDIs for provider education · Identifies coding trends based on payer denials, rejections, and claim edits · Presents audit findings bi-monthly to the team and educates the team based on findings · Reviews work completed by the coder, and if the coder is in error, returns to the coder with education to complete · Obtains required number of CEUs for current certification and completes required education · Identifies incorrect admit/discharge dates and patient type and sends to the appropriate department to update · Covers any open work queues (WQs) during end of month push or when a supervisor or manager requests Skills & Requirements: ·...