Memorial Healthcare System
Healthcare
InpatientCodingComplianceAuditor-HIM-FT-Days-RemoteEligible
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Inpatient Coding Compliance Auditor - HIM - FT - Days - Remote Eligible at Memorial Healthcare System. Skills: Inpatient coding, Outpatient coding, Coding compliance, Medical record auditing. Audit inpatient medical records. Audit outpatient medical records”
Industry & Context.
Critical thinking; Decisive judgment
Work with minimal supervision, Work in stressful environment, Take appropriate action
What They're Looking For.
Must Have
3 years inpatient coding experience, 3 years outpatient coding experience, Accredited Program Health Information Management, Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Assign and sequence ICD-10-CM/PCS and CPT codes, Proficient in basic computer skills, Utilizing a computerized encoder, Utilizing electronic medical record systems
Nice to Have
CPC – Certified Professional Coder, HCC - Hierarchical Condition Category Coder, CRC – Certified Risk Adjustment Coder, CPMA Certified Professional Medical Auditor
What You'll Do.
Audit inpatient medical records
Audit outpatient medical records
Review APC assignment
Review MSDRG assignment
Review APRDRG assignment
Follow official coding guidelines
Follow regulatory requirements
Provide training and education
Maintain knowledge of coding principles
Conduct electronic medical record audits
Verify coding accuracy
Verify grouping accuracy
Serve as expert resource
Assist developing departmental goals
Support strategic plan
Analyze claim denials
Resolve claim denials
Respond to external coding audits
Coordinate coder intern education
Develop coder intern training
Implement coder intern training
Align training with AHIMA standards
Provide feedback on audit results
Track coder intern progression
Maintain patient confidentiality
Hold educational sessions
Act as liaison for query process
Tailor education to increase accuracy
Assist coding staff format queries
Assess compliance with query standards
Report audit results to management
How You'll Work.
Team & Collaboration
Inpatient coding managers; Outpatient coding managers; Coding staff; Documentation specialists; Physicians
Communication Scope
Verbal communication; Written communication
Full Job Description
**Location:** Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. **Summary:** Responsible for auditing coded inpatient or outpatient medical records applying ICD-10 CM/PCS and/or CPT-4. Reviews Ambulatory Payment Classification (APC), Medicare Severity Diagnosis Related Groups (MSDRG) and All Patients Refined Diagnosis Related Groups (APRDRG) assignment and queries following official coding guidelines and regulatory requirements. Provides training and education based on audit results and any regulatory changes that effect Federal, State and American Health Information Management Association (AHIMA) guidelines. **Responsibilities:** Maintains thorough knowledge of ICD-10CM/PCS, and CPT coding principles and guidelines; possesses substantial knowledge of MSDRG, APRDRG, APC, and Enhanced Ambulatory Patient Groups (EAPG) classification systems and query guidelines for compliant provider documentation.Conducts and reports on electronic medical record audits to verify ICD-10CM/PCS, CPT and APC, MSDRG, and APRDRG coding and grouping accuracy. Serves as an expert resource for all coding staff. Assists with developing specific departmental goals, standards, and objectives which directly support the strategic plan and vision of the organization.Works closely with inpatient and outpatient coding managers to analyze and resolve claim denials that are rejected by edits from the Revenue Cycle Department. Reviews and responds to all external coding denial audits using ICD-10CM/PCS, CPT and APC, MSDRG, and APRDRG audits.Performs all other duties as assigned.Coordinates, develops, and implements coder intern education and training. Training will align with AHIMA standards of ethical coding and official coding guidelines. Provides feedback based on audit res
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