Assists with coordinating the coding audit functions of the Health Information Management Department. Audits coders’ and other auditors’ performance on a regular and continuous basis. Prepares and distributes audit results/reports for the system coding compliance program. Identifies trends and educational opportunities and assists with training. Prepares and presents educational programs related to coding. Assists with other audits as requested. Serves as a knowledge expert and maintains up-to-date working knowledge of coding guidelines in order to act as resource and point person for issues and question for coders, customers, project teams and committees.
Responsibilities and Duties
- Perform preliminary and routine audits on coding staff for each client site
- Audit coder’s work on a weekly and bi-weekly basis, and send audit results to leadership.
- Develop client-specific procedures document for each client based on their policies and procedures
- Must possess a thorough knowledge of ICD-9 / ICD-10 CM coding principles and applications as they relate to Physician Coding.
- Must have comprehensive and experience with E/M and Outpatient Surgical coding in multiple specialties.
- Ensure optimal reimbursement of all cases in compliance with CMS policies and procedures and Official Coding Guidelines
- Abide by the Standards of Ethical Coding as set forth by AHIMA and AAPC
- Ability to effectively utilize computerized encoder and/or other reference guides
- Ability to read, decipher and analyze all aspects of medical record documentation for accurate coding
- Knowledge of various clinical information systems, encoders and other technologies to facilitate a successful virtual work environment while maintaining maximum communication and adhering to HIPAA security standards
- Complete work assignments independently
- Participate in orientation training activities and review material provided
- Ability to work effectively individually as well as in a team environment
Analytical – Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
Quality – Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality
Problem Solving – Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
Technical Skills – Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.
Oral Communication – Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
Written Communication – Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
Planning/Organizing – Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives; Organizes or schedules other people and their tasks; Develops realistic action plans.
- Auditing: 3 years (Required)
- Medical Coding: 5+ years (Required
- AAPC or AHIMA Certified (Required)