NON-CLINICAL CODING AUDITOR AND TRAINER

Carson-Tahoe Regional Healthcare; Carson City (NV); On-site; USD 70,000 - 95,000; Full time

Job summary

Carson Tahoe Health is seeking a Non-Clinical Coding Auditor and Trainer to review outpatient records for ICD-10 and CPT coding accuracy and to educate providers on compliant coding and documentation practices.

The role includes conducting period audits, reporting findings, and coordinating with HIM leadership to improve coding practices and minimize errors, while staying current with regulatory changes.

Qualifications

• Active credentials listed (CCS, RHIT, RHIA, or AAPC or equivalent).
• Five years coding/auditing experience (preferred).
• Strong knowledge of ICD-10, CPT/CPT II/PCS, and coding compliance.

Responsibilities

• Audit provider medical records and charges for coding accuracy and compliance with standards.
• Report on CPT and ICD-10 coding accuracy to ensure payer, legal, and regulatory compliance.
• Educate providers and coders on coding/reimbursement/documentation requirements.
• Document and promote compliance standards and ethical billing practices.
• Collaborate with HIM and Coding leadership on new provider audits and education.

Skills

AHIMA CCS

AHIMA RHIT

AHIMA RHIA

AAPC

Education

CCS/RHIT/RHIA/AAPC or equivalent credentials

Job description

NON-CLINICAL CODING AUDITOR AND TRAINER - 5525

US:NV:Carson City | Information Management | Full Time

Description

US:NV:Carson City Health Information Management

Full Time Standard Office Hours

Summary

The Non-Clinical Coding Auditor and Trainer reviews services provided and compares them to EHR and billing records to determine accuracy. This position is responsible for performing quality reviews of outpatient medical records to validate the integrity of ICD-10 diagnoses and procedures as well as CPT/CPT II/PCS coded procedures. The position reviews medical records and other documentation to identify under and over coded services, prepares reports of findings and meets with management to educate on and improve coding practices. The Coding Auditor and Trainer ensures appropriate coding and maintains compliance documentation. This position ensures that billing is optimized, and errors are minimized by identifying opportunities through audit and observation; remaining abreast of regulatory and procedure changes which may affect coding compliance and /or reimbursement.

Qualifications

Required

• One of the following active credentials:
• AHIMA CCS
• AHIMA RHIT
• AHIMA RHIA
• AAPC or equivalent

Preferred

• Five (5) years coding/auditing experience

Essential Functions

• Audit Carson Tahoe provider’s medical records and charges to ensure compliance with coding standards.
• Reports on the accuracy of CPT and ICD-10 coding to ensure compliance with payer, legal and procedural policies and regulatory guidelines.
• Educate Carson Tahoe providers and coders to appropriate coding, reimbursement and documentation as required by medical review and regulatory requirements.
• Document effective auditing and compliance program including standards of conduct with respect to ethical billing practices.
• Participates in the development and application of written policies promoting Carson Tahoe’s commitment to Compliance and addressing specific areas of potential fraud.

Conduct periodic meetings with Carson Tahoe providers to include:

• Chart reviews
• Coding reviews for over/under coding patterns
• Coding patterns in general and in specific
• Address over coding and/or under coding issues individually with Carson Tahoe providers.
• Work closely with HIM and Coding leadership to complete new provider audits, including documentation review during first month and audit of charges to ensure coding accuracy.
• Provide education to Providers and coders as necessary regarding updates coding/billing changes.
• Participate in special audits as instructed.
• Performs other related duties as assigned.