- Full time, permanent, Facility Inpatient Auditor
- Responsible for performing coding quality audits on a wide variety of inpatient services.
- The position requires this auditor to be highly proficient in the proper assignment of ICD-10-CM, PCS, CPT, HCPCS and modifier codes.
- Demonstrated ability to provide direction to coding staff as it relates to coding integrity, effective and compliant query application and adherence to facility procedures.
- Provides written, detailed rationale and supporting evidence for recommendations on audit findings.
- Delivers educational feedback to coding staff regarding audit findings.
- Provides guidance to coding staff and management in identifying and resolving coding issues.
- Collaborates with the clinical documentation improvement team for conflicts between code assignments.
- Identifies documentation improvement opportunities that impact coding accuracy.
- Initiates physician queries for clarification of documentation in the medical record to achieve accurate code assignment and coding integrity.
- Reviews and researches billing edits.
- Assists with DRG denials from payers including researching and writing appeal letters.
- Ability to interpret Medicare and NCCI guidelines, National and Local Coverage Determinations to support coding compliance.
- Performs other duties as assigned including training/mentoring of new staff and performing research related to special projects
Other Job Functions:
- Reports results of audits t