Under the direction of the Director of Medical Coding, the Coding Auditor performs departmental and interdepartmental coding audits to ensure compliance with Federal and State regulations. The Coding Auditor has thorough knowledge of Acute Care facility Federal and State reporting guidelines, CPT/HCPCS coding, UB-04 Revenue coding, modifiers, sequencing rules and the National Correct Coding Initiative (NCCI) edits, AHA Coding Clinic, Official Guidelines for Coding and Reporting for ICD-9-CM, ICD-10-CM, ICD-10-PCS coding conventions, DRG and APC payment classifications and Medicare Conditions of Participation. The Coding Auditor will identify cases coded incorrectly and provide feedback and education to the Coder. Responsible for the timely and accurate transfer of corrected data from quality reviews to hospital computer systems. Responsible for adhering to the Medical Coding Department's coding compliance program. Maintains professional standards following the AHIMA professional code of ethics. Enforces Medical Coding Department policies and procedures.
Knowledge of State and Federal regulatory requirements governing Coding and Billing.
Minimum 5 years in acute care hospital facility inpt/outpt coding, auditing or related work required. Experience working with SMART software product, knowledge of 3M encoder and EPIC software strongly preferred. CCS or equivalent required. RHIT/RHIA preferred. Associate degree or equivalent preferred. Demonstrated ability to work with all internal and external customers in a professional manner. Ability to orient and train new / trainee coders
Location/Region: Westwood, CA