Coding Auditor I

MN Climate Innovation Finance Authority (MNCIFA); United States; Remote; USD 60,000 - 90,000; Full time

Job summary

The Coding Auditor 1 is responsible for conducting coding quality audits to ensure compliance and accuracy in medical coding. This role requires proficiency in ICD-10-CM/PCS and CPT codes, and offers competitive benefits, including immediate health benefits and a 401(k) plan.

Benefits

Immediate health and welfare benefits eligibility

401(k) plan with dollar-for-dollar match up to 5%

Tuition Reimbursement

PTO starting Day 1

Qualifications

• 5 years of coding experience, including 1 year as a coding auditor.
• Must possess RHIA, RHIT, CCS, CCS-P, CIC, COC, CPC, or CIRCC certification.

Responsibilities

• Perform routine coding quality reviews on all coders.
• Provide feedback based on coding quality audits.
• Work collaboratively to enhance accurate, complete documentation.

Skills

Knowledge of ICD-10-CM/PCS coding

Knowledge of CPT procedural coding

Strong interpersonal skills

Strong verbal communication skills

Demonstrated competency with computer applications

Education

H.S. Diploma/GED or equivalent

Job description

Description

JOB SUMMARY

The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback to coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT), and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC, etc.).

ESSENTIAL FUNCTIONS OF THE ROLE

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

KEY SUCCESS FACTORS

• Strong knowledge of applicable rules, regulations, policies, laws, and guidelines impacting the coding area.
• Strong knowledge of transaction code sets, HIPAA requirements, and other issues impacting coding and abstracting functions.
• Strong knowledge of anatomy, physiology, and medical terminology.
• Demonstrated competency in using computer applications, group software, and Correct Coding Initiatives (CCI) edits.
• Strong 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.
• Strong interpersonal, verbal, and written communication skills.
• Skill in the use of computers.
• Flexibility and adaptability while balancing regulatory and accreditation guidelines.

QUALIFICATIONS

• Education: H.S. Diploma/GED or equivalent.
• Experience: 5 years of coding experience, with at least 1 year as a coding auditor.
• Certification/Registration: Must possess one of the following with 5 years of coding experience, including 1 year as a coding auditor: RHIA, RHIT, CCS, CCS-P, CIC, COC, CPC, CIRCC.

BENEFITS

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

ABOUT BAYLOR SCOTT & WHITE HEALTH

As the largest not-for-profit healthcare system in Texas and one of the largest in the U.S., Baylor Scott & White includes 52 hospitals, over 1,300 care sites, more than 7,200 physicians, and over 57,000 employees.

More jobs from Baylor Scott & White Health include roles such as Insurance Verification Specialist, Auditor, and Inpatient Coding Auditor, available in various locations including Texas, Virginia, Maine, and Florida.

Details for remote positions are currently unavailable.