Coding Auditor 1

NACBA; Northern (KY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health benefits

401(k) savings plan

Tuition Reimbursement

PTO accrual Day 1

Job summary

Baylor Scott & White Health is seeking a Coding Auditor 1 to conduct coding quality reviews using ICD-10-CM/PCS, HCPCS, CPT and other references. You will provide feedback to coders and ensure accurate classification and MS-DRG/APC groupings, collaborating with Clinical Documentation Specialists to improve documentation.

Ideal candidates bring 5 years in coding with applicable certifications (CCS, RHIA, RHIT, CPC, etc.) and at least 1 year as a coding auditor, with strong knowledge of HIPAA and

Qualifications

• EDUCATION - HS Diploma or GED required.
• EXPERIENCE - 5 years coding experience.
• CERTIFICATION/REGISTRATION - must hold CCS, CCS-P, CIC, CIRCC, COC, CPC, RHIA, or RHIT (or equivalent) and at least 1 year as coding auditor.

Responsibilities

• Performs routine coding quality reviews on coders, including third-party suppliers.
• Collaborates with internal customers to review coding quality and provide feedback.
• Abstracts and validates data elements into the coding/abstracting system.
• Works with Clinical Documentation Specialists to improve documentation accuracy.
• Completes production coding as assigned.

Skills

ICD-10-CM/PCS coding knowledge

HIPAA regulations

Anatomy & medical terminology

CCIs and coding edits

Interpersonal communication

Proficiency in coding abstracts and QA

Proficiency with coding references

Education

HS Diploma/GED

Tools

Coding and abstracting system

Job description

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.

Our Core Values are:

• We serve faithfully by doing what's right with a joyful heart.
• We never settle by constantly striving for better.
• We are in it together by supporting one another and those we serve.
• We make an impact by taking initiative and delivering exceptional experience.

Benefits

Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include:

• Immediate eligibility for health and welfare benefits
• 401(k) savings plan with dollar-for-dollar match up to 5%
• Tuition Reimbursement
• PTO accrual beginning Day 1

Note: Benefits may vary based upon position type and/or level.

Job Summary

The Coding Auditor 1 is skilled in various coding types. They perform coding quality audits and give feedback to coders. The Coding Auditor 1 uses ICD-10-CM/PCS, HCPCS, CPT, and other coding references. These references ensure accurate coding and classification assignment grouping, like MS-DRG, APR-DRG, and APC.

Essential Functions of the Role

• Performs routine coding quality reviews on all coders including third party suppliers as appropriate.
• Performs coding quality reviews in collaboration with or for internal customers of the organization.
• Provides feedback as appropriate depending on findings.
• Abstracts and validates required data elements into the coding and abstracting system.
• Works collaboratively with the Clinical Documentation Specialists and Coaches to communicate opportunities for accurate, complete, and compliant documentation.
• Completes production coding when needed and assigned by one over.

Key Success Factors

• Exceptional knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area.
• Exceptional knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function.
• Exceptional knowledge of anatomy, physiology, and medical terminology.
• Demonstrated proficiency of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits.
• Exceptional knowledge of ICD-10-CM/PCS coding and/or CPT procedural coding.
• Ability to interpret health record documentation to identify procedures and services for accurate code assignment.
• Exceptional interpersonal verbal and written communication skills.
• Skill in the use of computers.
• Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables.
• Must have one of these registrations or certifications and 5 years of coding experience. At least 1 year should be as a coding auditor.
• Registered Health Information Administrator (RHIA)
• Registered Health Information Technologist (RHIT)
• Certified Coding Specialist (CCS)
• Certified Coding Specialist Physician-based (CCS-P)
• Certified Professional Coder (CPC)
• Certified Outpatient Coder (COC)
• Certified Inpatient Coder (CIC)
• Certified Interventional Radiology Cardiovascular Coder (CIRCC)

Belonging Statement

We believe that all people should feel welcomed, valued and supported.

QUALIFICATIONS

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - 5 Years of Experience
• CERTIFICATION/LICENSE/REGISTRATION - Cert Coding Specialist (CCS), Cert Coding Spec Physician Bas (CCS-P), Cert Inpatient Coder (CIC), Cert Interv Radiology CV Coder (CIRCC), Cert Outpatient Coder (COC), Cert Professional Coder (CPC), Reg Health Info Administrator (RHIA), Reg Health Information Technic (RHIT): Must have one of these certifications and 5 years of coding experience. At least 1 year should be as a coding auditor.