Memorial Healthcare System

Healthcare

InpatientCodingComplianceAuditor-HIM-FT-Days-RemoteEligible

$75–105k ~AI est. Miramar, Florida, United States FULL TIME
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Mid+ candidates.

The Brief

“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.

Healthcare
Problems you'll solve

Critical thinking; Decisive judgment

Eligibility Requirements

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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