Ambulatory Services Auditor – CDS 1
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Job Description
Ambulatory services auditor reviewing healthcare coding and documentation for St. Charles Health System. Ensuring ICD-10-CM and CPT-4 compliance across outpatient, inpatient, and ambulatory services.
Responsibilities:
- Conduct system-wide pre-visit or post-visit chart reviews of professional services in hospital and clinic/office settings
- Audit and monitor all lines of system business for coding, including outpatient, inpatient and ambulatory services
- Perform audits for the HIM Professional Services Coding team and provide feedback and education
- Evaluate medical records for clinical documentation accuracy, HCC capture and recapture, and diagnostic/procedural code integrity
- Develop and update procedure manuals for correct coding
- Assist with system-wide education and training in professional services coding
- Assist in setting direction for coding compliance and education
- Provide technical guidance to physicians and departmental staff on documentation and coding issues
- Recommend process and policy improvements to reduce losses or improve efficiency
- Monitor trends and prepare reports on documentation, coding issues, and denied claims
- Support organizational vision, mission, values, Lean continuous improvement, safety, confidentiality, compliance, and customer service
- Perform additional duties of similar complexity as assigned
Requirements:
- High school diploma or GED
- Required: RHIA, RHIT, CCS-P, CPC, CPMA, CRC, RN, or LPN
- 0-3 years of coding experience required, or an equivalent combination of education and experience
- Knowledge of current Medicare regulations, including MPFS, IPPS and OPPS
- Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely
- Ability to use a clear and audible speaking voice and hear normal speech level
- Ability to sit, stand, walk, lift 1-10 pounds, operate a keyboard, bend, climb stairs, reach overhead, carry/push/pull 1-10 pounds, grasp/squeeze, and perform other listed physical requirements
- Must work Monday-Friday, 07:00-15:00, First Shift (United States of America)
Benefits:
- Comprehensive benefits including Medical, Dental, Vision for you and your immediate family
- 403b with up to 6% match on Retirement Contributions
- Generous Earned Time Off
- Growth Opportunities within Healthcare
- Remote work from an approved state by St. Charles
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