Review Consultant

Health Information Associates (HIA); Pawleys Island (SC); On-site; USD 70,000 - 110,000; Full time

Job summary

Health Information Associates (HIA) seeks a remote compliance auditor to review inpatient and outpatient records for ICD-10-CM/PCS and CPT coding accuracy. You will write concise recommendation worksheets and executive summaries, and communicate findings to coders and hospital administration.

The role requires five years of acute care coding experience, RHIA/RHIT or CCS credentials, and proficiency with EHR systems, coding software, and online resources.

Qualifications

• Minimum 5 years inpatient and outpatient coding experience in an acute care facility.
• RHIA, RHIT, or CCS credential is required.
• Proficiency with EHR and coding software, plus online resources.

Responsibilities

• Reviews records to ensure codes reported are accurate to ICD-10-CM/PCS and CPT conventions.
• Validates admission orders, dates, patient status, and related indicators for accuracy.
• Uses 3M and other tools to analyze codes, sequencing, and edits.
• Runs preliminary and final statistical and coder-specific reports.
• Prepares for Exit Conference and communicates with Administration and Coding staff.

Skills

Coding experience

Remote work

EHR experience

Research skills

Communication skills

Education

High School Diploma with RHIA/RHIT/CCS

Tools

3M Coding Tool

Groupers

Job description

• This is a remote/work from home position *

Overview

Performs compliance audits of Inpatient and/or Outpatient medical records in accordance with all coding guidelines. Writes and presents concise recommendation worksheets with appropriate findings and coding references to coders during education exits. Writes Executive Summaries and must communicate with different administrative levels within the hospital.

Responsibilities

• Reviews records assigned to ensure all codes reported are accurate to ICD-10 CM/PCS and/or CPT coding conventions
• Reviews additional chart documentation to validate admission order, admission and discharge dates, point of origin, patient status, present on admission indicator, and coder queries to ensure accuracy
• Uses various software applications, groupers, 3M and other coding tools to analyze and ensure appropriate codes, sequencing and edits
• Runs preliminary and final statistical and coder specific reports
• Completes client rebuttals and makes appropriate changes in database
• Prepares for Exit Conference using Teams
• Conducts Exit Conference with Administration
• Conducts Exit Conference with Coding Staff
• Prepares summation of Exit Conference
• Meets with HIM Director following Exit

Qualifications

• High School Diploma with RHIA, RHIT, or CCS credential
• Minimum 5 years inpatient and outpatient coding experience in an acute care facility.
• Computer proficiency, able to research coding questions and utilize HIA’s internal educational resources
• Experience using Electronic Health Record (EHR)
• High Speed Internet via Cable (no Satellite or wireless cell based)
• Independent, focused individual able to work remotely.
• Sound organizational, communication and critical thinking skills