The Coding Auditor performs 2nd level review of coded cases to ensure accuracy and completeness of all ICD-10-CM/ CPT/ HCPCS codes assigned by HIM Coding Technicians on a daily basis. All assigned codes must be supported by clinical documentation contained in the record and must be in compliance with Federal Coding Compliance regulations.;;Additionally, the Coding Auditor will provide reports and analysis of accuracy rates; compliance rates; etc.and recommend education topics based on audit find... more details
Description
The Coding Auditor performs 2nd level review of coded cases to ensure accuracy and completeness of all ICD-10-CM/CPT/HCPCS codes assigned by HIM Coding Technicians on a daily basis. All assigned codes must be supported by clinical documentation contained in the record and must be in compliance with Federal Coding Compliance regulations. ; ;Additionally, the Coding Auditor will provide reports and analysis of accuracy rates; compliance rates; etc.and recommend education topics based on audit findings and assist in the training & continuing education of HIM Coding Technicians. ; ;Coding compliance audit of Inpatient; Outpatient Ambulatory Surgery and Ancillary Services; Emergency ;Department medical record coding.
Core Competencies
Reviews the assignment and sequencing of codes for the principal diagnosis, principal procedure, complications and comorbid (CC) conditions, and other significant invasive and non-invasive procedures that should be coded according to ICD-10-CM official guidelines for coding and reporting, published by the U.S. Department of Health and Human Services (DHHS) and the AHA Coding Clinic for ICD-10-CM.
Reviews the assignment and sequencing of codes for the principal procedure, other significant invasive and non-invasive procedures according to the coding conventions and guidelines outlined in the CPT code set, the National Correct Coding Initiative (NCCI), the Outpatient Coding Editor (OCE), and the AMA CPT Assistant publication.
Collects data and generates reports.
Demonstrates competency in performance of coding functions by maintaining current knowledge in ICD-10-CM, CPT, and HCPCS coding.
Monitors all for payment by the Accounting Department, and maintains accurate files on purchases, orders and requisitions.
Department Specific Competencies
Answers the telephone, responds to requests for assistance, and resolves concerns or complaints in a timely manner.
Additional Information
Completion of an ‘American Health Information Management Association' (AHIMA) or an ‘American Academy of Professional Coders' (AAPC) approved/sanctioned ICD-10-CM & CPT-4 coding certification program. Completion of: (1) Medical Terminology and (2) Anatomy & Physiology courses.
Experience
Number of Years Experience
Type of Experience
10
All levels of coding & abstracting (i.e. Inpatient, Emergency Department, Ambulatory Surgery
Additional Information
Two years previous Coding Auditor/2nd Level Review experience
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