Hospital Coding Auditor

St. Tammany Parish Hospital

Job Description

The Coding Auditor is responsible for performing pre-bill and retrospective medical record audits to ensure accurate Medicare MS-DRG/APC assignment and ICD-10-CM/PCS and CPT coding on inpatient and/or outpatient cases in accordance with facility and Official Coding Guidelines. Provides guidance on documentation requirements, queries and documentation improvement processes.

In addition, the Auditor is responsible for maintaining concise documentation of audit findings for each coder throughout the year to ensure accurate reporting to Department Head and Compliance Committee as appropriate. Responsible for communicating and developing educational information based on audit findings clearly outlining areas of opportunity for coders, physician documentation, documentation specialist and other areas as deemed appropriate.

Minimum Qualifications: Bachelor's degree in Health Information Management, required or Bachelor's degree in a related field may be substituted in lieu of a degree in Health Information Administration with extensive experience in performing medical record coding audits for acute care hospitals. CCS, Certified Coding Specialist, required.

Minimum of 7-10 years inpatient coding or auditing experience; Knowledge of Medicare, Medicaid and other third party payer documentation, coding and billing regulations; Knowledge of clinical pertinence and the impact it has on the documentation process as a whole; Ability to set priorities and meet deadlines; Requires critical thinking skills, decisive judgment and the ability to work with minimum supervision. Strong analytical skills to clinically review and evaluate medical record documentation; Experience with working in an Electronic Medical Record (EMR); proficient in utilizing Microsoft Products to develop education material for coders and physicians (Excel, Word, PowerPoint, Outlook); strong written and verbal communication skills to effectively present audit findings in clear and concise terms to Senior Leadership, physicians, coders and other hospital personnel.

Preferred Qualifications: RHIA, Registered Health Information Administration or RHIT, Registered Health Information Technician, preferred.

Physical Demands:

Must possess good physical health. Some requirements include but are not limited to standing, sitting or walking for long periods of time. Lifting at least 10 pounds is required.

Physical Effort required: Constant (67%-100%) - handling/feeling, hearing, seeing

Frequently (34%-66%) - reaching

Occasionally (1%-33%) - lifting, carrying, stooping, talking

Employment Type