• Mommy Jobs On Line
  • $85,510.00 -120,820.00/year*
  • Bethel Park, PA
  • Accounting
  • Full-Time
  • 5500 Main St

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The Inpatient and Outpatient Coding Compliance Auditor will provide expert auditing services across various hospitals for Inpatient and all Outpatient services. Review documentation and related coding of inpatient and outpatient services, auditing correct assignment of CPT, ICD - 10 - CM / PCS, HCPCs, to verify coding and billing accuracy and that coders base code assignment in a manner consistent with relevant laws, regulations, coding and billing standards. This individual will provide education to coders on audit results, utilize expertise to research and respond to challenging coding questions, develop and provide coding education and evaluate audit results to recommend corrective actions. The individual will have the expertise to respond to client requests to conduct ad hoc coding and billing audits.

Primary Responsibilities:

Perform coding compliance and quality audits in support of Optum360's Compliance Program and client expectations
Analyze and interpret documentation from medical records
Clearly document audit findings and calculate billing error rates
Provide feedback and education as appropriate depending on findings
Articulate audit findings appropriate for audience. Prepare written audit reports as needed summarizing audit findings and any corrective action necessary to mitigate risk
Serve as an expert coding resource to client organizations and provide expert coding guidance to other clinical hospital departments
Conduct ad hoc coding and billing audits as requested
Educate and audit offshore coders and auditors as well as audit and educate new coders
Stay abreast of relevant LCDs, NCDs, billing and coding guidelines concerning the current areas of audit focus
Research, develop and present education programs to physicians, coders and management as requested

Required Qualifications:

Bachelors Degree in related concentration such as Health Information Management or Health Information Technology or equivalent experience

7+ years coding experience
5+ years of audit experience
Proficient in application of acute hospital coding guidelines, policies, processes and practices
Must maintain active coding credential by obtaining qualifying CEUs as needed
Extensive, current knowledge of acute hospital coding rules, official coding guidelines and policies regarding ICD - 10 - CM / PCS, MS - DRG, and CPT / APC
Exceptional technical skills in most software applications such as Excel, Word and Outlook
Highly experienced and comfortable in most Electronic Medical Records and encoder / grouper products
Comfortable and very experienced in leading remote education and training sessions to a group or individuals while using WebEx and other similar applications

Preferred Qualifications:

Experience with computer assisted coding (CAC) products

To Become A Member: Please visit www.mommyjobsonline.com and click on Join Now and select the Medical Coding WAH Job Bank Registry to become a member to get connected with this client. Please email us your resume after you register with your qualifications and work history.

Please reference agent id code MJOLRebeccan on your registration submission.

Please feel free to consult with us if you have further job related questions about our company at 1-405-###-####.

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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