Coding Auditor

Northwell Health; Village of Lake Success (NY); On-site; USD 70,000 - 100,000; Full time

Job summary

Northwell Health seeks an experienced coder/auditor to conduct coding audits, develop instruction classes, and prepare coding guidelines. You will implement coding changes and educate staff while staying current on Federal and State guidelines.

The role requires 1–3 years of relevant experience and CPC/CCP credentials. Responsibilities include validating coding accuracy, communicating with coders and CDI staff, and monitoring case mix index.

Qualifications

• Bachelor's Degree required, or equivalent combination of education and related experience.
• Current Coding credential: CPC or CCP, required.
• 1-3 years of relevant experience required.
• The salary details are a good faith determination of potential base compensation at the time of posting.

Responsibilities

• Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.
• Demonstrates effective skills in validation; provides ad-hoc education to the coding staff.
• Able to communicate effectively with coders and CDI staff.
• Demonstrates knowledge of coding policy and procedures.
• Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies.
• Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing.
• Reviews potential reassignments; demonstrates accurate and timely review of all reassignments.
• Implements coding changes; demonstrates ability to relate coding changes accurately and efficiently to staff.
• Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.
• Work assignments are varied and require interpretation and independent decisions on course of action.
• Understands department, division, corporate strategy and operating objectives, including impacts.
• Normally receives general instructions on routine work, detailed instructions on new projects or assignments.
• Majority of contact is within own function, area, or department and may be customer service oriented.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act.

Skills

Coding audits

Education to staff

Communication

Policy knowledge

Federal/state guidelines knowledge

Education

Bachelor's Degree

CPC/CCP credential

Job description

Job Description

Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines; implements coding changes.

Job Responsibility

• Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.
• Demonstrates effective skills in validation; provides ad-hoc education to the coding staff.
• Able to communicate effectively with coders and CDI staff.
• Demonstrates knowledge of coding policy and procedures.
• Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies.
• Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing.
• Reviews potential reassignments; demonstrates accurate and timely review of all reassignments.
• Implements coding changes; demonstrates ability to relate coding changes accurately and efficiently to staff.
• Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.
• Work assignments are varied and require interpretation and independent decisions on course of action.
• Understands department, division, corporate strategy and operating objectives, including impacts.
• Normally receives general instructions on routine work, detailed instructions on new projects or assignments.
• Majority of contact is within own function, area, or department and may be customer service oriented.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• Bachelor's Degree required, or equivalent combination of education and related experience.
• Current Coding credential: CER - Cert Professional Coder. (CPC) OR CER - Certified Professional Coder (CCP), required.
• 1-3 years of relevant experience required.
• Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).