Coding Auditor Inpatient - Virtual 

Work Hours/Shift:

• Full Time Virtual 

• Performs quality reviews on coded records to validate ICD-9, ICD-10, ICD-10-PCS, MSDRG, APRDRGs, and overall coding accuracy retrospectively and concurrently at all AdventHealth campuses including other Adventist Health Systems facilities as needed
• Provides continuing education to individual coders and to the coding staff concerning changes in the coding and reimbursement system as well as any area of weakness identified during the performance of coding validation reviews
• Prepares statistical reports conveying the individual and overall accuracy of coding
• Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist.  Effectively communicates with physicians and allied health personnel the need for comprehensive, accurate and timely clinical documentation
• Assists with writing compelling appeals to all DRG denials from outside agencies referencing Official Coding Guidelines and Coding Clinic advice as appropriate to defend the DRG assignment as well as protect the organizations reimbursement

Qualifications

What Will You Need:        

EDUCATION AND EXPERIENCE REQUIRED:

• High school diploma and two years of coding education (medical coding certificate program or 2-year HIM program), including medical terminology, anatomy and physiology, and pathophysiology coursework.
• Five or more (5 ) years of inpatient hospital coding and/or auditing experience, including cases requiring specialized coding skills, such as cardiovascular surgery, neurosurgery, trauma surgery, neonatology, pediatrics, plastic and reconstruction surgery, bariatric surgery, cardiology, and other services and procedures provided in a tertiary care facility.

EDUCATION AND EXPERIENCE PREFERRED:

·       Bachelor’s Degree

·       Comprehensive experience with cases requiring more complex coding skills, such as advanced cardiovascular, cardiothoracic, neurological, and orthopedic surgical procedures, extended or prolonged length of stays (> 100 days), BMT and other solid organ transplantations, ECMO, cutting-edge surgical advancements that are considered new and innovative, procedures that may be considered experimental or research-based, and other complicated treatments or procedures provided in a quaternary care facility.  

LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:

• RHIA, RHIT, CCS, CPC, or CIC certification with required years of experience                   

The Inpatient Coding Auditor, under general supervision, is responsible for validating the coding that is performed by inpatient or outpatient coders. Random samples and/or target samples are reviewed and the results are provided to management as well as feedback to the individual coder.  Assists with education of all coders and Medical Staff members, while educating throughout the organization as needed.  Maintains extensive knowledge of all coding standards and is able to effectively communicate to all appropriate individuals. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

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