Coding Auditor

Job not on LinkedIn

🔥 2 minutes ago

🐊 Florida, Idaho, +9 more states – Remote

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💵 $28 - $39 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

🦅 H1B Visa Sponsor

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👻 Ghost score 0%

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Logo of Riverside Health

Riverside Health

5001 - 10000 employees

Founded 1915

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Riverside Health is a comprehensive health care provider offering a wide range of medical services, including primary care, urgent care, specialty care, and emergency care. The organization is dedicated to enhancing the health and well-being of the communities it serves through compassionate care, innovative treatment options, and a commitment to excellence. Riverside Health provides access to specialized services such as mental health care, women's health, orthopedic services, cancer care, and more. This organization also focuses on education and support for various life stages, and offers resources like clinical trials and wellness education through blogs and podcasts. They maintain a strong community presence with outreach programs and partnerships intended to improve health. Riverside Health also offers digital access to health records through MyChart, ensuring patients can manage their health information conveniently. Their mission is to care for others with the same dedication they would show to their loved ones, focusing on patient-centered care and community impact.

📋 Description

• Maintain coded data quality through ongoing quality review and assessment of outpatient or inpatient records • Audit accuracy of APC or MS-DRGs and medical record documentation needed for accurate coding • Work with DRG and CPT denials from commercial payers and write appeal letters as indicated • Ensure coding compliance using Coding Clinic, leading authorities, standardized coding standards, conventions, regulations, corporate compliance standards, and reimbursement policies • Identify training needs and provide education to team members • Teach or coordinate coding huddles and coach and mentor staff • Perform focused reviews and quality audits and prepare audit reports for leadership • Assist coding leadership with reviewing and responding to internal and external coding audits • Work with coding leadership to settle audit findings as needed • Monitor and evaluate coding functions for effective and efficient operations and compliance • Audit documentation opportunities to clarify confusing, incomplete, or conflicting information and obtain additional documentation when needed • Assist patient financial services and clinical documentation improvement team members with coding and billing edit questions • Serve as a clinical coding liaison and analyze documentation issues with medical, clinical, CDI, and other departments • Assist leadership with coordination of iCare initiatives related to the hospital coding department • Assist with DRG and certain CPT payer denials, write appeals, and document denials/audits in the denial management tool for tracking and reporting

🎯 Requirements

• High School Diploma or GED (Required) • 5-6 years Acute Care Inpatient (IP) and Outpatient (OP) Coding (Required) • 2 years Auditing - Acute Care IP and OP (Required) • Current working knowledge of ICD-9, ICD-10 and CPT coding principles, government regulation, and protocols • Intermediate proficiency with Excel, PowerPoint, and Word • Skill in completing assignments accurately and with attention to detail • Ability to adapt to changes in the work environment • Excellent interpersonal skills and team oriented • Ability to communicate effectively in both oral and written form • Certified Coding Specialist (CCS) certification through AHIMA upon hire (Required) • AHIMA ID or credential number provided on application or resume • Preferred: Associates Degree in Healthcare or Related • Preferred: 1 year Clinical Documentation Integrity • Preferred: RHIA, RHIT, CCDS/CDIP, or CPC certification upon hire

🏖️ Benefits

• Remote work eligibility for candidates residing in FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, or VA

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