OP Coder Auditor

Prime Healthcare; Racimo (CA); On-site; USD 39,000 - 59,000; Full time

Job summary

Prime Healthcare is seeking an Outpatient Coder Auditor to join our California-based team. The role focuses on reviewing outpatient medical records, ensuring ICD-10/PCS, CPT and HCPCS codes are accurate and well supported by clinical documentation.

The ideal candidate will hold CCS certification, have knowledge of ICD-10-CM, CPT, HCPCS, and healthcare coding processes; experience with encoder software and hospital coding environments is preferred.

Qualifications

• CCS is required.
• Medical Graduate, PA or Nursing Graduate.
• Familiar with Hospital and Professional Coding, Infusion Injection Coding.
• Thorough knowledge of ICD-10-CM, CPT, anatomy and physiology, medical terminology, APCs.

Responsibilities

• Review and analyze documentation in outpatient medical records to ensure accurate ICD-10/PCS, CPT, and HCPCS codes.
• Finalize coding and abstracting after clinical documentation review.
• Participate in chart review projects and other duties as needed.

Skills

ICD-10-CM knowledge

CPT knowledge

Medical terminology

Critical thinking

Education

Medical Graduate

PA or Nursing Graduate

CCS certification

Tools

encoder software

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation's leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Responsibilities

The Outpatient Coder Auditor reviews and analyzes documentation present in the medical record for Outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. The Outpatient Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications of Diseases,Tenth revision (ICD-10/PCS), Current Procedural Terminology (CPT), and Health Care Procedure Coding System (HCPCS), are accurate and supported by the clinical documentation of the respective medial record. Participates in chart review projects as assigned and other duties as needed.

Qualifications

Education and Work Experience

Required qualifications:

• Medical Graduate, PA or Nursing Graduate.
• CCS is required.
• Familiar with Hospital and Professional Coding, Infusion Injection Coding.
• Thorough knowledge of ICD-10-CM, CPT, anatomy and physiology, medical terminology, , APC's.

Preferred qualifications:

• Registered Health Information Technician (R.H.I.T.), or Registered Health Information Administrator (R.H.I.A.).
• One year of clinical experience in acute care setting preferred.
• Basic computer experience required.
• Use of an encoder software product for code assignment in an acute care setting required.
• Computer data entry with 10-key preferred, with accurate typing speed of 35 wpm preferred.
• Excellent written and verbal communication skills. Excellent critical thinking skills.

Pay Transparency

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $28.00 to $43.40. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf