CRC/DRG Coding Auditor
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Job Description
Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignments for compliance. Engages with facility leaders on coding best practices.
Responsibilities:
- Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record.
- Validates abstracted data elements that are integral to appropriate payment methodology.
- Consulting: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding.
- Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures.
- Adheres to Standards of Ethical Coding (AHIMA).
- Uses discretion and specialized coding training and experience to accurately assign ICD-9, CPT-4 codes to patient medical records.
- Identifies and communicates documentation improvement opportunities and coding issues to appropriate personnel for follow-up and resolution.
- Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-9-CM and CPT coding.
Requirements:
- Associates degree in relevant field preferred or combination of equivalent of education and experience
- Three years coding experience including hospital and consulting background
- Ability to consistently code at 95% accuracy and quality while maintaining client specified production standards
- Must successfully pass coding test
- Knowledge of medical terminology, ICD-9-CM and CPT-4 codes
- Must be detail oriented and have the ability to work independently
- Computer knowledge of MS Office
- Must display excellent interpersonal skills
- The coder should demonstrate initiative and discipline in time management and assignment completion
- The coder must be able to work in a virtual setting under minimal supervision
- Intermediate knowledge of disease pathophysiology and drug utilization
- Intermediate knowledge of MSDRG classification and reimbursement structures
- Intermediate knowledge of APC, OCE, NCCI classification and reimbursement structures.
Benefits:
- Medical, dental, vision, disability, life, and business travel insurance
- Paid time off (vacation & sick leave) – min of 12 days per year, accrued at a rate of approximately 1.84 hours per 40 hours worked.
- 401k with up to 6% employer match
- 10 paid holidays per year
- Health savings accounts, healthcare & dependent flexible spending accounts
- Employee Assistance program, Employee discount program
- Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
- For Colorado employees, paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.
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