Coder Auditor

Prime Healthcare; Ontario (CA); On-site; CAD 39,000 - 59,000; Full time

Job summary

Prime Healthcare is seeking an Inpatient Coder Auditor to review documentation for inpatient visits and ensure accurate ICD-10-CM, CPT, and HCPCS coding. The senior role emphasizes DRG validation and primary responsibility in assisting CDS and medical staff to improve the quality of clinical documentation.

You will participate in chart review projects as assigned and other duties as needed, requiring a strong grasp of DRGs, anatomy, and medical terminology, along with encoder software experience

Qualifications

• Must be a medical graduate, PA, or nursing graduate.
• Certification CCS required.
• Minimum one year of clinical experience in an acute care setting.
• Strong knowledge of ICD-10-CM, CPT, anatomy and physiology, DRG/APC/Severity DRGs.
• Experience using encoder software for code assignment.
• Typing speed 35 WPM with accurate data entry.
• Excellent written and verbal communication skills.
• Strong critical thinking abilities.

Responsibilities

• Review and analyze inpatient records to ensure code accuracy.
• Finalize coding with ICD-10-CM, CPT, HCPCS per documentation.
• Support CDS/medical staff to improve documentation quality.
• Participate in chart review projects as needed.

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Responsibilities

The Inpatient Coder Auditor reviews and analyzes documentation present in the medical record for Inpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Inpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications of Diseases, tenth revision (ICD-10/PCS), Current Procedural Terminology (CPT), and Health Care Procedure Coding System (HCPCS), are accurate and supported by the clinical documentation of the respective medial record. Holding a senior coding position assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation. Participates in chart review projects as assigned and other duties as needed.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

• 1. Medical Graduate, PA or Nursing Graduate


• 2. Certified Coding Specialist (CCS)


• 3. One (1) year of clinical experience in acute care setting


• 4. Thorough knowledge of ICD-10-CM, CPT, anatomy and physiology, medical terminology, DRG's, APC's, Severity Adjusted DRG's


• 5. Use of an encoder software product for code assignment in an acute care setting


• 6. Computer data entry with 10-key preferred, with accurate typing speed of 35 wpm


• 7. Excellent written and verbal communication skills


• 8. Excellent critical thinking skills

Pay Transparency

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $28.00 to $43.40. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf