Remote Inpatient Auditor

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timePosted 5 days ago location United States salarySalary undisclosed
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Job Description

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Job Summary:

- 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.

Primary functions:

- 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