Field-Based ICD-10 Coding Auditor - DRG & Billing Audits

DaMar Staffing; New Jersey; On-site; USD 75,000 - 100,000; Full time

Job summary

Integrated Resources, Inc is seeking a Coding Auditor (ICD-10) to conduct on-site audits of hospital billing and coding practices in the Newark/Wall area. Desk audits, forms development and tracking institutional audit trends are part of the role.

The position requires guidance on ICD-9-CM/ICD-10, DRG assignment, payment and auditing, with travel 85–90% across NJ, PA & NY and training responsibilities for new staff.

Qualifications

• Requires a Bachelor's degree in Health Information Management or related field.
• Experience in a medical records department of an acute care hospital or health care facility.
• Experience with DRG validation, ICD-9-CM or ICD-10 training and education.
• RHIA or RHIT certification; or RN with CCS certification.
• Valid driver's license and access to a car.

Responsibilities

• Identifies and presents billing discrepancies found during audit and coordinates referral of improper claim payments through the appropriate channels.
• Identifies error trends as they relate to medical record and/or billing documentation or misinterpretation of provider contract stipulations.
• Compiles statistics and other audit information to present to accounts, regulatory agencies, and internal requesters.
• Reviews and updates audit processes with manager for keeping up with new innovations in clinical data review and cost containment.
• Train new staff on department/audit procedures.
• Performs other assignments as requested by manager.
• Conforms to laws, regulations and policies pertaining to the organizational unit.

Skills

Medical terminology

Anatomy & physiology

Utilization management

Hospital payment systems

CMS regulations

Education

Bachelor's degree in Health Information Management or related field

RN with CCS certification

RHIA or RHIT certification

Tools

ACCESS Software

Job description

Integrated Resources, Inc is seeking a Coding Auditor (ICD-10) to conduct on-site audits of hospital billing and coding practices in the Newark/Wall area. Desk audits, forms development and tracking institutional audit trends are part of the role.

The position requires guidance on ICD-9-CM/ICD-10, DRG assignment, payment and auditing, with travel 85–90% across NJ, PA & NY and training responsibilities for new staff.