Hospital Coding Auditor

Baptist Health Care; Pensacola (FL); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Restaurant discount

Job summary

Baptist Health Care is seeking a Coding Auditor to review and audit patient records for correct ICD-10-CM/PCS codes, CPT codes, POA assignment and MS-DRG assignment. The role will issue quarterly report cards and provide coding training and education to coders.

The ideal candidate has at least five years of inpatient and/or outpatient coding experience and holds CCS, CPC, and CCA certifications. Knowledge of Medicare and other third-party payer regulations is required.

Qualifications

• Technical diploma or coding certificate required.
• Minimum 5 years inpatient and/or outpatient coding experience.
• Experience with Medicare and other third-party payer regulatory issues.
• CCS_AHIMA, CPC_AAPC, and CCA_AHIMA certifications required.

Responsibilities

• Audit patient records for correct ICD-10-CM/PCS codes, CPT codes, POA assignment and MS-DRG assignment.
• Issue quarterly coding report cards to coders.
• Provide coding training and education to staff.
• Collaborate with DRG assignment with CDIS and educate on missed query opportunities.
• Inform manager of activities not meeting federal or state coding and billing requirements.
• Appeals RAC DRG review charts and respond to business office issues within 5 working days.
• Assist in discharge summary reviews for coding accuracy; support operational needs; may be required on campus before, during, and after severe weather or disasters.

Education

Technical Diploma/Certificate Coding

CCS_AHIMA

CPC_AAPC

CCA_AHIMA

Job description

Job Description

The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals.

Responsibilities

Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment. Informs manager of any activities which do not meet federal or state coding and billing requirements. Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds within 5 working days, if possible. Reviews discharge summaries for coding accuracy. Assists in identification of potential identity errors. Coding Clinics are reviewed and applied appropriately. Assist in other duties as assigned to support the operational needs of the department and organization. May be required to remain on campus immediately before, during, and after severe weather and/or disasters.

Qualifications

• Minimum Education
  • Technical Diploma/Certificate Coding Required
• Minimum Work Experience
  • 5 years Inpatient and/or outpatient coding experience Required
  • Experience in regulatory issues related to Medicare, and other third party payers as it relates to hospital and ambulatory coding and billing. Required
• Licenses and Certifications
  • Certified Coding Specialist (CCS_AHIMA) Required
  • Certified Professional Coder (CPC_AAPC) Required
  • Certified Coding Associate (CCA_AHIMA) Required

Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC maintains and enforces a policy that prohibits discrimination against any workforce members or applicants for employment because of sex, race, age, color, disability, marital status, national origin, religion, genetic information, or other category protected by federal, state or local law.