Coding Compliance Auditor - Coding Services Non-Exempt; Non-Union

Coding Compliance Auditor - Coding Services - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD‑10‑CM, and HCPCS assignments and accuracy and completeness of all codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation within the medical record and must comply with federal coding regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant.

The Auditors also provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics regarding coding accuracy rates, compliance rates, denial analytics, etc. The Auditor recommends education topics based on audit findings and assists in the continuing education of professional coders and providers.
Keeps coding systems such as Cerner, Medi Tech, Epic, and Athena IDX in a manner that ensures clean claims release for billing in a timely manner.

• CODING AUDITING:
  Performs monthly internal coding audits to evaluate accuracy of coding staff and ensures required coding accuracy rate; develops monitoring/education plans for staff who do not meet the required accuracy rate; recognizes education needs of staff based on monthly reviews and conducts related in‑services, as needed; acts as a resource to coding staff, USC Care staff, and providers on coding issues and questions;
  
  achieves 95% accuracy rate as determined by an annual external review of coding.
• GENERAL SUPERVISION:
  Professional coding of all diagnostic and procedural information from medical records using ICD‑10‑CM, and CPT/HCPCS, and Modifier classification systems; works cooperatively with Coding Support and/or CBO to obtain documentation to complete medical records and ensure optimal and accurate assignment of diagnosis and procedure codes; attends, is punctual, and demonstrates professionalism; consistently assumes responsibility and displays reliability for completion of tasks and communications;
  
  performs other duties as requested by director, manager, supervisor, or designee.
• TIMELINESS OF AUDITING/CODING & PRODUCTIVITY:
  Maintains at minimum expected productivity standards and strives to maintain a steady level of productivity; works coding queues/task lists to ensure charges are released within defined timelines; assists other coders in performing duties, answering questions, and providing guidance; assists Billing, USC Care coding department, and other departments in addressing coding issues/questions and providing information so that charges can be generated;
  
  assists physicians, APPs, physician office staff, and hospital ancillary department staff with coding issues/questions; assists in monitoring unbilled accounts to ensure oldest records are coded or given priority.
• POLICY & PROCEDURES; PERFORMANCE IMPROVEMENT:
  Consistently adheres to coding policies and procedures as directed by Coding management; demonstrates understanding of policies and procedures and seeks clarification as needed; participates in continuously assessing and improving departmental performance; communicates changes to improve processes to the director as needed; assists in department and section quality improvement activities and processes (i.e., Performance Improvement).
• COMMUNICATION:
  Works and communicates in a positive manner with management, supervisory staff, medical staff, co‑workers, and other healthcare personnel; communicates effectively intra‑departmentally and inter‑departmentally; communicates effectively with external customers; provides timely follow‑up with both written and verbal requests for information, including voicemail and email; performs other duties as assigned.

• High school or equivalent.
• Successful completion of college courses in Medical Terminology, Anatomy & Physiology, and a certified coding course.
• Combined education/experience can substitute for completion of specialized/technical training courses.
• Five (5) years of experience in ICD‑9 & ICD‑10 (combined)…