HIM Outpatient Coding Auditor
Conducts outpatient coding quality audits to validate code assignment is supported by clinical documentation in the medical record. Highly proficient in the proper assignment of ICD-10 CM, ICD PCS, CPT, HCPCS, and modifier codes.
- Education: Associates degree in Health Information (RHIT), or associates degree in applicable healthcare field.
- Experience 3-5 years progressive coding experience in acute care hospital setting, including auditing
- Certification/Licensure: AHIMA or AAPC certification required, such as RHIA, RHIT, CCS, CIRCC, CPC, COC
- Software/Hardware: Meditech and 3M 360 experience required
- Other: Required to work out of Steward Health Care office located in Richardson, Texas.
- Travel: Expected travel is up to 10%. Education and/or company growth.
- Performs coding audits of a wide variety of complex outpatient services including outpatient surgical, observation, emergency department, diagnostic outpatient, clinic, and series accounts. Also prefer experience in interventional radiology, E&M leveling and coding of injections and infusions.
- Provides written, detailed rationale and supporting evidence for recommendations on audit findings.
- Delivers educational feedback to coding staff regarding audit findings.
- Provides guidance to coding staff and management in identifying and resolving coding issues.
- Identifies documentation improvement opportunities that impact coding accuracy.
- Reviews and researches billing edits.
- Ability to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding compliance.
- Performs other duties as assigned including training/mentoring of new staff and performing research related to special projects