Cleveland Clinic
Your source for health news, tips and information from one of the nation’s top hospitals.
Coding Quality Auditor
Location
United States
Posted
35 days ago
Salary
Not specified
High School5 yrs expEnglish
Job Description
• Assess the accuracy and completeness of inpatient and outpatient medical record documentation through the conduct of random and focused coding audits.
• Document findings, prepare and present audit results and perform investigations to provide comprehensive feedback.
• Serve as a subject matter expert in coding, offering guidance and support to ensure compliance with established coding standards, regulatory requirements and organizational best practices.
• Audit Electronic Medical Records, procedural cases and surgical cases, including pre-bill coding, DRG and APC quality audits, case mix analysis and compliance software reviews for highly complex cases.
• Provide feedback on the application of coding guidelines, practices, proper documentation techniques, data quality improvements and revenue enhancement opportunities.
• Perform retrospective and concurrent audits in accordance with coding guidelines to ensure coding accuracy and proper reporting.
• Prepare and present reports for pre-bill and retrospective coding audits directly to Providers and coding staff.
• Analyze coded data to identify areas of risk and provide recommendations for documentation improvement.
• Assist in the development of programs and procedures to improve coding accuracy rates.
• Interact with Providers and coding staff to resolve documentation or coding issues.
• Respond to coding questions from assigned coders and Providers, providing official coding references and guidelines.
• Maintain routine interaction with Providers and coding staff to address and resolve medical record documentation and coding issues.
• Assist in the facilitation of scheduled external audits.
Job Requirements
- High School Diploma and five years of professional coding experience OR Associate’s Degree and four years of professional coding experience OR Bachelor’s Degree and three years of professional coding experience
- ONE of the following certifications is REQUIRED and must be maintained: AHIMA Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), or AAPC Certified Inpatient Coder (CIC) or Certified Professional Coder (CPC)
- Proficient in Microsoft Office Applications (e.g., Word, Excel)
- In depth knowledge of ICD-10-CM/PCS coding principles, CPT coding principles, DRG assignment, APC assignment and modifier assignment
- Knowledge of human anatomy and physiological disease processes
- Knowledge of medical terminology
- Knowledge of auditing concepts and principles
- Coding assessment relevant to the work may be required
Benefits
- Health insurance
- Medication coverage
- Retirement savings plan
- Paid time off
- Flexible work arrangements
- Professional development opportunities
Related Guides
Related Categories
Related Job Pages
More Auditor Jobs
Auditor36 days ago
Full TimeRemoteTeam 10,001+Since 1811H1B Sponsor
Lead Auditor for regulatory compliance and quality assurance in Aerospace industry
Cyber Security
Auditor37 days ago
Full TimeRemoteTeam 10,001+H1B No Sponsor
Inpatient Coding Auditor ensuring coding compliance and education in healthcare setting
Auditor39 days ago
Full TimeRemoteTeam 10,001+Since 1963H1B No Sponsor
Senior Analyst for SOX Audit evaluating IT application controls at CVS Health
CloudCyber Security
Auditor39 days ago
Full TimeRemoteTeam 10,001+H1B Sponsor
Medical Claims Auditor reviewing and analyzing claims for healthcare compliance