Cleveland Clinic

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Coding Quality Auditor

AuditorAuditorFull TimeRemoteTeam 10,001+H1B SponsorCompany SiteLinkedIn

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

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