Coding Auditor

Northwell Health; Village of Lake Success (NY); On-site; USD 65,000 - 90,000; Full time

Job summary

Northwell Health in New York is seeking a Coding Auditor to optimize DRG groupings, develop instruction classes, and prepare coding guidelines. You will implement coding changes and collaborate with CDI staff.

The role requires a Bachelor's degree, CPC or CCS credential, and 1–3 years of coding experience. Knowledge of federal and state coding guidelines is essential, with strong communication and education skills.

Qualifications

• Bachelor's degree in healthcare, HIM, or related field.
• Current CPC or CCS credential required.
• 1-3 years of relevant coding experience.
• Experience with edits and denials is a plus.

Responsibilities

• Conducts coding audits to optimize DRG groupings.
• Develops and implements coding instruction classes.
• Prepares and updates coding guidelines.
• Implements coding changes and communicates to staff.
• Maintains knowledge of federal and state coding guidelines.

Skills

Coding audits

Regulatory guidelines

Staff education

Communication

Data interpretation

Education

Bachelor's Degree

CPC or CCS certification

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: Cert Professional Coder – CPC or CCS required.


• 1-3 years of relevant experience required.


• Experience with edits and denials a plus.

*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).