Coding Auditor

Northwell Health; Village of Lake Success (NY); On-site; USD 60,000 - 80,000; Full time

Job summary

Northwell Health is seeking a qualified coding auditor to optimize DRG classifications and develop instructional coding classes. You will audit codes, prepare guidelines, and implement coding changes.

The role requires a Bachelor's degree, CPC or CCS credential, and 1-3 years of relevant experience; knowledge of federal/state guidelines and ability to educate staff are essential.

Qualifications

• Bachelor's Degree or equivalent required.
• Current CPC or CCS credential required.
• 1–3 years of relevant experience preferred.
• Experience with edits and denials preferred.

Responsibilities

• Conducts coding audits to optimize DRG classifications.
• Prepares coding guidelines and implements coding changes.
• Provides ad-hoc education to coding staff and communicates with coders and CDI staff.
• Maintains knowledge of current Federal and State coding guidelines.
• Monitors and evaluates case mix index and reassignments as needed.
• Operates under general guidance with independent decisions on course of action.

Skills

CPC/CCS credential

Coding guidelines knowledge

Communication skills

Education

Bachelor's Degree or equivalent

Job description

196762

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 preferred.
• 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).