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Posted: 30-Jan-25
Location: Orlando, Florida
Categories:
Internal Number: 24038940
Work Hours/Shift:
- Full Time Remote
- 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
What Will You Need:
EDUCATION AND EXPERIENCE REQUIRED:
- At least five years proven acute care hospital inpatient coding experience
EDUCATION AND EXPERIENCE PREFERRED:
- Previous coding auditing experience
- Successful completion of at least a two-year coding education program
LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:
- RHIA, RHIT, or CCS certification or credential
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.
