CODING AUDITOR | Consulting and Auditing

Salina Regional Health Center

CODING AUDITOR

POSITION SUMMARY
Audit charts of professional or acute inpatient to insure proper coding is assigned resulting in proper reimbursement for conditions treated, procedures performed, etc. Auditors will perform quality reviews on records coded by hospital coding staff as well as professional coding staff to validate that ICD 10 codes and DRG assignments are accurate and consistent with coding guidelines, insurance regulations and government rules and regulations. Documentation will be reviewed and educated on to insure all needed information is present in the record to support the code assignment. Any discrepancies or findings will be discussed in a collaborative manner and substantiated with coding guidance supported by AHIMA and as published by the American Medical Association. It is imperative for the auditor to be able to decipher rules and regulations and apply them to charts being audited independently and to educate in alliance with their findings.

POPULATION SERVED: n/a
OSHA CATEGORY III

ESSENTIAL JOB FUNCTIONS

QUALITY
Audit charts of professional or acute inpatient to insure proper coding is assigned resulting in proper reimbursement for conditions treated, procedures performed, etc.
Auditors will perform quality reviews on records coded by hospital coding staff as well as professional coding staff to validate that ICD 10 codes and DRG assignments are accurate and consistent with coding guidelines, insurance regulations and government rules and regulations.

ACCESS
Auditor will be able to decipher rules and regulations and apply them to charts being audited independently and to educate in alignment with their findings.

STEWARDSHIP
Documentation will be reviewed and educated on to insure all needed information is present in the record to support the code assignment.
Assist in training providers and coders to insure compliance and quality.

ORGANIZATIONAL VALUES

PATIENT CENTERED
Keeps the welfare of the patient at the center of all decisions and actions by maintaining a customer-centered focus at all times.
Advocates for patients and their families by practicing behaviors that create a culture of patient focused activity.

QUALITY
Expects excellence of self and others.
Questions the status quo; uses creativity and innovation to engage in performance and process improvement.
Identifies and mitigates risk.

INTEGRITY
Is honest and ethical in all matters.
Demonstrates teamwork/cooperation within and across departments, understanding others perspectives and resolving conflict constructively.

TRUST
Safeguards the privacy, security, and confidentiality of protected health information at all times.
Treats all people with dignity; supports diversity; and understands related issues.
Is flexible and adaptable to change; demonstrates a positive and supportive attitude; and willingly accepts change.

SUSTAINABILITY
Holds self and others accountable in the use of SRHC supplies, and completion of tasks in a timely, efficient, and productive manner.
Volunteers for or accepts new or additional duties/responsibilities for the greater good of the department, organization, and/or patient.

POSITION QUALIFICATIONS

MINIMUM EDUCATION
Completion of a professional medical coding program

MINIMUM EXPERIENCE
Two years coding or auditing experience

REQUIRED REGISTRATION/LICENSE/CERTIFICATION
CPC, CCA, RHIT, or RHIA

PHYSICAL DEMANDS
Lifts, positions, pushes and/or transfers up to 10 pounds
Primarily sedentary work
Manual dexterity and mobility
Near acuity: ability to see clearly at 20 inches or less

WORKING CONDITIONS
Subject to many interruptions; pressure due to multiple calls, inquires, and/or deadlines
Remote or on-site work options

EMPLOYEE ACKNOWLEDGEMENT
In signing the job description, I attest that I will adhere to Salina Regional Health Center’s policies, procedures, and regulatory standards, including but not limited to complying fully with the Corporate Compliance Program and Code of Ethical Conduct; and participating actively in the Quality Assessment and Performance Improvement Plan, including identifying and mitigating risk to patients.

I acknowledge that I have read, understand, and accept the qualifications, responsibilities, and performance expectations outlined in the job description.  I recognize that these duties form the basis for my performance evaluations, and that management reserves the right to assign additional tasks or change existing essential job functions as operational needs dictate.  I confirm that I am able to perform the essential functions of this position with or without reasonable accommodation.