Inpatient Coding Auditor

Job Title: BACK-OFFICE OPERATOR

Specialization: Inpatient Facility Coding Audit Specialist

Location: Irving, Texas, Remote

Mandatory Skills:

• 2+ years previous experience as an inpatient coding auditor
• 3+ years previous experience in coding inpatient hospital accounts
• Certified Coding Specialist (CCS) or Registered Health Information Technician/Administrator (RHIT/RHIA) credentials

Position Summary:

Under minimal supervision and according to established policies and procedures, conducts retrospective inpatient coding quality review audits in compliance with the coding compliance plan and established standards.

Supports the review activities that drive hospital revenue including revenue cycle initiatives, internal audit plan, reimbursement audits and data quality.

Key support for the coding areas and staff.

Duties and Responsibilities:

Essential Functions:

• Performs coding quality audits and reports results for accurate ICD-10-CM and ICD-10-PCS coding of the principal diagnosis, secondary diagnosis, principal and secondary procedures, present on admission (POA) indicators, and DRG assignment.
• Identifies missed query opportunities for complete and accurate revenue within the federal, state and payer specific regulations and coding policies.
• Conducts quality review of medical record abstracting and appropriate discharge disposition selection to ensure revenue integrity and data quality.
• Provides analysis and trending of coding quality and opportunities; interprets coding data to identify quality concerns, trends and root causes related to denials.
• Ensures compliance with coding standards and government regulations.
• Maintains knowledge of coding and billing requirements and regulatory changes.

Skills and Abilities Required:

• Analytical ability to gather and interpret data, to evaluate reports and track progress of initiatives and to determine methods for ensuring revenue integrity and coding compliance.
• High degree of interpersonal skills to effectively communicate with internal and external customers, including physicians, clinicians, management and coding staff.
• In-depth technical knowledge of ICD-10-CM/ICD-10-PCS guidelines/coding clinics, CPT coding conventions, DRG and APC assignment, medical terminology, anatomy, and disease processes.
• Proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Outlook).
• Excellent time management skills; organized; ability to prioritize completing multiple tasks on schedule in a deadline-driven environment.
• Ability to interact with internal and external customers in a professional manner.
• Ability to ramp up on a client’s environment, processes, historical context, and systems to provide support to an engagement as soon as possible.

Education, Experience & Licensure:

• 2+ years previous experience as an inpatient coding auditor
• 3+ years previous experience in coding inpatient hospital account