Analysis Skills, Auditing, Certified Coding Specialist (CCS), Clinical Study Publications, Critical Care, Current Procedural Terminology (CPT), Diagnosis-Related Group (DRG), Documentation, Federal Laws and Regulations, High School Diploma, Hospital, ICD-10, Medical Coding, Medical Records, Neurology, Outpatient Care, Patient Care, Pay-Per-Click Advertising, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Regulatory Compliance, Reimbursement, State Laws and Regulations, Surgical Procedures, Time Management, Training/Teaching
Coding Compliance Auditor
Linthicum Heights, MD 21090 (Remote)
13 Weeks – Contract
Shift:Day 5x8-Hour (08:00 - 17:00)
Schedule:
- Shift hours can be flexible and discussed with the manager. The core business hours are 6a-6p
- Must be based in EST or CST hours (cannot recruit from Hawaii, Alaska, or California)
Contract:
Important Call Outs:
- Assessment will be given to qualified candidates identified by client. Assessment will need to be completed and scored before proceeding with interview
- Temp to Hire Opportunity. Please ensure candidates are aware.
Required Qualifications
Education:
* High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training.
* Associates or Bachelor’s degree. Education will be considered in lieu of experience.
Experience:
* Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma hospital or 4 years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience.
*Must have inpatient auditing experience
Certifications:
* One of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC)
Key Responsibilities:
Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems.
Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.
o Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations.
o Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment.
• KEY RESPONSIBILITY 2: Serves in an advisory and educator role for Coding Specialists. Serves as communicator between Clinical Documentation Specialists and Coding. Researches new surgical procedures and technology. Provides training to new employees
o Reports coding quality accuracy rate for each coder
o Monitors productivity rate for each coder
o Conducts specialized focused audits as needed.
• Key Responsibility 3: Communicates with various departments within the hospitals regarding coding accuracy. Refers any problems to management timely, providing clear details. Assist coding specialists in writing appropriate coding queries, works collaboratively with CDI, understand Potentially Preventable Complications (PPC’s)/Maryland Hospital Acquired Conditions (MHAC’s), Prevention Quality Indicators (PQI’s) and their impact and other indicators as needed.
• KEY RESPONSIBILITY 4: Complies with AHIMA standards of ethical coding and coding compliance guidelines.
• KEY RESPONSIBILITY 5: Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager.