The Auditor conducts clinical coding audits as defined by client contracts for audit service and internal quality assessment according to operational guidelines. The Audit staff will also contribute to the ongoing development and refinement of proprietary audit tools. The Auditor Position will serve as the primary mentor/trainer to internal coders as required by the deliverables of the contract and will be required to provide educational feedback and instruction to staff for coding guidelines as part of the internal quality review.
Essential Responsibilities
Client Related Duties –
- Coordinate and oversee the coder onboarding process for assigned clients.
- Manage the performance of all quality for assigned clients. Monitor and enforce compliance and quality program. Ensure adherence to State and National Practice Standards for coding.
- Serve as an official resource for coding related questions from the coding staff.
- Provide project status reports to operational leadership, as requested.
Auditing Team Duties –
- Monitor employee coding accuracy rates on a weekly basis. Work directly with coding management team to ensure educational needs of coder are met. Provide coaching, as needed.
- Assures internal coding audits are completed accurately and timely
- Conducts coding audits adhering to nationally recognized coding guidelines and standards
- Perform auditing for a broad spectrum of cases
- Provides input and advice regarding educational topics based on audit trends
- Represents company via professional meeting attendance and communication
- Interacts with audit peers, manager, coding staff and operations team
- Abides by the Standards of Ethical Coding as set forth by AHIMA
- Maintains appropriate QA/QI and/or productivity logs or record entries
- Additional duties as assigned
Maintain Coding Knowledge and Serve as Coding Expert –
- Attend internal and external meetings, as needed and requested to provide input and act as a coding information resource/expert.
- Ensure AQuity’s compliance with all regulatory agencies. Ensure we are HIPAA compliant at all times.
Requirements:
- Minimum 3 years of IP Auditing experience
- Must have experience in either academic or trauma inpatient coding or audit
- CCS credential required
- Broad-based audit experience with inpatient and outpatient ICD-10-CM/PCS and CPT coding.
- Requires strong interpersonal communication skills, both verbal and written
- Requires a high level of coding accuracy and attention to detail
- Experience with using multiple encoders and systems
- Excellent oral and written communication skills – must be detailed and articulate
- Strong knowledge of Microsoft Word, Excel, PowerPoint, and Outlook is required
- Inpatient Auditor candidates must demonstrate a comprehensive knowledge of the DRG structure and regulatory requirements.
Why Work for AQuity:
We offer competitive benefits such as:
- Competitive salary
- Full Benefit package including medical, dental, vision, short and long term disability and voluntary life insurance
- 401(k) with matching
- Three weeks of paid time off (120 hours) annually
- Seven paid holidays annually
- Job related education reimbursement, CEU and credentials
Qualifications
Experience
Required
Broad-based audit experience with inpatient and outpatient ICD-10-CM/PCS and CPT coding.
3 years: 3 years IP Auditing experience
Licenses & Certifications
Required
Cert. Coding Specialist
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