Auditor

Coronis-Health-LL; Mandaluyong; On-site; PHP 300,000 - 500,000; Full time

Job summary

Coronis-Health-LL is seeking a Medical Coding Auditor to ensure accuracy in medical records coded by coders and to communicate findings effectively for quality and compliance. The role requires up-to-date knowledge of coding guidelines and HIPAA/privacy practices, with a focus on identifying undercoded or upcoded services during audits.

The auditor will prepare reports, educate coding staff, and collaborate with operations to maintain confidentiality and adherence to facility-specific

Qualifications

• Bachelor’s Degree in Medical Records or allied field
• CCS/CPC/CCS-P/CIC/COC/CCA certification preferred
• Minimum of 3 years IP auditing experience

Responsibilities

• Audits medical records coded to identify undercoded or upcoded services.
• Prepares reports and communicates findings to coders with education on errors.
• Keeps current with Official Coding and reporting Guidelines and CMS directives for ICD-10 coding.
• Maintains updated facility guidelines and ensures confidentiality of information.
• Attends coding education sessions for updated coding information and changes.
• Able to think independently with impartial judgment.
• Maintains HIPAA privacy and security compliance.
• Performs coding when needed to support production.
• Acts as a team player and adheres to HR and department policies.
• Assists with other tasks as business requires.

Skills

Auditing

Communication

HIPAA compliance

Coding review

Education

Bachelor’s Degree in Medical Records or allied field

CCS/CPC/CCS-P/CIC/COC/CCA certification

Job description

Medical Coding Auditor is responsible in maintaining accurate audit to medical records coded by the coders and communicate with them on the findings. Auditor must ensure compliance to coding guidance, facility specific instructions and confidentiality of information. Reviews and develop reports essential for quality and compliance standards. Medical coding auditor reports to Operations and Quality.

Essential Functions:

1. Audits medical records that are coded to identify possible undercoded and/or upcoded services.
2. Prepares reports of the findings and meets with the respective coder to communicate clearly the errors and provide education in line with appropriate coding practices and compliance issues.
   • Inpatient Specialty : principal diagnosis, secondary diagnosis, procedures (ICD 10 PCS), Diagnosis-Related Group (DRGs), Present On Admission (POA) findings, discharge disposition.
3. Stays current with Official Coding and reporting Guideline, CMS directives for ICD 10 coding and conducts intensive research for acceptable source of references in coding updates, disease process, procedure details etc., to provide accurate audit and feedback to coding staff.
4. Keeping updated to facility specific guidelines and compliance to ensure accuracy in auditing.
5. Attends necessary coding education sessions to receive updated coding information and changes in coding and/or regulations.
6. Able to think independently and impartial judgment.
7. Able to adapt on technologies use in coding and auditing.
8. Maintains confidentiality of information.
9. Adheres to all HIPAA privacy and security policies and practices. Reports violations and incidents they observe and cooperates in investigations as requested by management.
10. Capable of doing coding to its minimum as needed in the production.
11. Perform as a team player
12. Attendance in accordance with company HR and department policies
13. Other tasks/functions that may be assigned by the company as per business requirement; these may change from time to time to reflect the changing requirement of your position and our business.

Education/ Experience:

Bachelor’s Degree in Medical Records or any Allied Medical Field.

Preferably possess a current CCS/CPC/CCS-P/CIC/COC/CCA (or equivalent) medical coder certification.

Must have at least three (3) years of IP auditing experience required.