What are the responsibilities and job description for the Coding Auditor position at Renown Health?
| Position Purpose: | |
| This position is responsible for the coordination of quality audits for coding staff. In addition, this position is responsible for auditing as part of the Coding Reimbursement Team and the reporting of audit results to Leadership. The emphasis of this position is to coordinate all aspects of audit entities, including outside request for compliance and billing, including and not limited to RAC and/or other auditing programs audit requests. This position is responsible to maintain departmental policies set forth by Leadership and keeping abreast of continual changes in coding and billing guidelines and compliance related to reimbursement within federal and State regulations. This incumbent is to have expert knowledge of accurately assigning ICD-9-CM/ICD-10-CM diagnostic and procedure codes for all aspects of facility coding. This list is to include Acute Inpatient, Level II Trauma, Rehab Facility, Skilled Nursing, Home Health as well as Hospice. ICD-9-CM/ICD-10-CM/PCS and CPT code assignments must be consistent with CMS Official Guidelines, regulatory agencies and hospital specific bylaws and guidelines. |
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| Nature and Scope: | |
| The major challenge of this position is to coordinate the coding staff auditing schedules for quality and proficiency to ensure compliance of Coding/Auditing, Coding and documentation quality, and that accurate reimbursement is being met with quality coding standards. This position is accountable for auditing information coded from provider documentation and patient medical records within the designated time frames in order to expedite the billing process ensure accurate reimbursement for services rendered and to promote compliance. All findings obtained in the auditing arena must be documented and reported to Coding and Financial Leadership. This position has access to proprietary information and has contact with external organizations, which mandates high standards of professionalism, communication, performance, and respect for confidentiality. This position is challenged to be aware of the continual changes in Federal and State regulations. This position is accountable to maintain departmental policies and bring issues and the need for revised/additional policies and procedures to management's attention. This person must be able to identify and resolve problems, set goals and priorities, and represent the department in a professional manner as well as in the absence of Leadership, as assigned. High standards of performance, courteousness, diplomacy, and respect for confidentiality are essential. Job responsibilities can include assignment of diagnostic codes by proficient analysis and translation of diagnostic statements, physician orders, and other pertinent documentation leading to coding accuracy and abstracting of pertinent data elements from documentation provided. The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job. Incumbent must have skill set to:
Other responsibilities include:
The incumbent must consistently meet or exceed productivity and quality standards as defined by the HIM Coding Leadership. Telecommuting is allowed with approval from HIM Management. KNOWLEDGE, SKILLS & ABILITIES
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| The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job. | |
| Minimum Qualifications: Requirements - Required and/or Preferred | |
| Education: | Must have working-level knowledge of the English language, including reading, writing and speaking English. Bachelors Degree in Health Information Management is preferred. |
| Experience: | A minimum of 4 or more years of progressively responsible and advanced experience in healthcare coding. Experience in all patient types as well as experience and knowledge of needed compliance criteria for all facility types is required. |
| License(s): | None |
| Certification(s): | CCS or RHIA/RHIT with a minimum of four years of facility coding experience is required |
| Computer / Typing: | Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. |
