Coding Compliance Auditor

Memorial Hermann Health System; Houston (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

A leading health care provider in the United States is seeking a Coding Compliance Auditor to ensure the accuracy and completeness of clinical coding. This mid-senior level position involves conducting coding audits, coordinating educational sessions forcoding staff, and adhering to coding and reimbursement guidelines. The ideal candidate will have four years of relevant experience and extensive knowledge of ICD‑10‑CM and CPT coding principles. This is a full-time position offering an opportunity to make a significant impact within the organization.

Qualifications

• Four years of relevant hospital coding or auditing experience required.
• Knowledge of reimbursement systems and regulations.
• Experience coding/auditing in a level 1 trauma facility preferred.

Responsibilities

• Conducts regular coding audits and coordinates ongoing monitoring.
• Develops and coordinates educational sessions for coding staff.
• Ensures compliance with coding guidelines and reimbursement requirements.

Skills

Extensive knowledge of ICD‑10‑CM and CPT coding principles

Effective oral and written communication skills

Knowledge of database applications and spreadsheet design

Education

High school diploma or GED

Tools

3M Coding applications

Job description

Coding Compliance Auditor at Memorial Hermann Health System

Job Summary

Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This position typically reports to the Coding Compliance Manager.

Minimum Qualifications

Education: High school diploma or GED, required.

Licenses/Certifications:

• Inpatient: RHIT, RHIA, CCA, CCS, or CIC; AHIMA/AAPC certification required.
• Outpatient: RHIT, RHIA, or relevant coding certification; AHIMA/AAPC certification required.

Experience / Knowledge / Skills:

• Four (4) years of relevant hospital coding or auditing experience required.
• Experience coding/auditing in a level 1 trauma facility/academic teaching facility strongly preferred.
• Extensive knowledge of ICD‑10‑CM and CPT coding principles and guidelines.
• Extensive knowledge of 3M Coding applications and resolving coding edits.
• Working knowledge of reimbursement systems and regulations and policies pertaining to documentation, coding, and billing.
• Knowledge of database applications and spreadsheet design.
• Effective oral and written communication skills.

Principal Accountabilities

• Conducts regular coding audits and coordinates ongoing monitoring of coding accuracy, providing continuous feedback to coding staff.
• Develops and coordinates educational sessions to all coding staff regarding documentation and accurate coding.
• Serves as a resource for coding staff on organization‑wide coding and documentation standards and guidelines.
• Designs audit tools to monitor the accuracy of clinical coding.
• Keeps abreast of coding guidelines and reimbursement reporting requirements.
• Conducts trend analyses to identify patterns and variations in coding practices.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department‑based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
• Other duties as assigned.

Seniority Level

• Mid‑Senior level

Employment Type

• Full‑time

Job Function

• Finance and Sales

Industries

• Hospitals and Health Care