Job Summary:
The auditor will perform second-level coding accuracy reviews to support improving quality for each outpatient clinical coder.
Job Duties:
The Auditor will perform focused second-level coding accuracy reviews to support improving coding accuracy for each Outpatient Clinical Coder. The Auditor will review a percentage of coding audits to identify relevant trends of inaccurate coding and areas that are high risk for compliance issues. Meticulous documentation will be maintained and reported to the Outpatient Coding Supervisor. The Auditor is responsible for giving feedback and providing education to the Outpatient Clinical Coders to ensure a 95% accuracy rate is maintained by the outpatient coding department. The Auditor will assist with conducting and investigating existing policies, guidelines, and precedent cases in publications such as the Federal Register, AHA Coding Clinic, and AHIMA Journal to support internal policy development. Other duties may be assigned.
SUPERVISORY RESPONSIBILITIES
This job has no supervisory responsibilities.
Qualifications:
EDUCATIONAL REQUIREMENT
One-year certificate from college or technical school in Medical Coding; or one and one-half years of related experience; or an equivalent combination of education and experience.
EXPERIENCE REQUIREMENT
An additional two (2) years of experience in a related field is required.
COMPUTER SKILLS
An individual should know Database software; Internet software and Spreadsheet software.
CERTIFICATES, LICENSES, REGISTRATIONS
One of the following certifications is required:
Certified Professional Coder (CPC); or
Certified Professional Coder Apprentice (CPC-A); or
Certified Professional Medical Auditor (CPMA); or
Certified Coding Specialist (CCS)
OTHER QUALIFICATIONS
The employee must not be and will not be under sanction by the United States Department of Health and Human Services Office of the Inspector General (OIG) or by the General Services Administration (GSA), or listed on the OIG's Cumulative Sanction Report, or listed on the GSA's List of Excluded Providers, or listed on the OIG's List of Excluded Individuals/Entities (LEIE).
PHYSICAL DEMANDS
While performing the duties of this Job, the employee is regularly required to sit. The employee is frequently required to use hands to finger, handle, or feel. The employee is occasionally required to talk or hear.
WORK ENVIRONMENT
The noise level in the work environment is usually very quiet.
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