Coding Auditor - Health Information Management

Position:Coding Auditor - Health Information Management

Location: Reno, NV

Job :422

# of Openings:1

The Coding Auditor is tasked with coordinating the auditing schedules of the coding staff to ensure quality and proficiency, thus ensuring compliance with coding/auditing standards and documentation quality. The primary challenge is to guarantee accurate reimbursement is achieved through adherence to high-quality coding standards. This role involves auditing information coded from provider documentation and patient records within designated time frames, facilitating the billing process, ensuring accurate reimbursement, and promoting compliance.

The incumbent must document and report all findings to Coding Leadership.

• Coordinate coding staff auditing schedules to ensure quality and proficiency.
• Audit information coded from provider documentation and patient records within designated time frames.
• Document and report all auditing findings to Coding Leadership.
• Address appeals and review necessary information for insurance denials to facilitate resolution and reimbursement.
• Participate in mandated Medical Record Review processes.
• Interpret and apply American Hospital Association (AHA) Official Coding Guidelines to support appropriate diagnoses and procedures.
• Possess knowledge of discharge disposition and reimbursement outcomes.
• Adhere to Health Information Management (HIM) Coding policies and The Joint Commission (TJC) documentation guidelines.
• Maintain coding certification and stay updated on ICD-10 coding guidelines and regulatory changes.
• Participate in performance improvement initiatives as assigned.

• Education:
  
  Bachelor's Degree in Health Information Management preferred.
• Experience:
  
  Minimum of 10 or more years of progressively responsible experience in healthcare coding, with at least 2 years of auditing experience in either facility or professional services coding.
• Certification: AAPC, AHIMA, or Certified Coding credential (excludes apprenticeship classification).
• Knowledge:
  Expert knowledge of coding conventions, CMS’ Official Guidelines for ICD-10-CM coding, Anatomy and Physiology, Disease Pathology, and Medical Terminology.
• Computer
  
  Skills:
  
  Must possess necessary computer skills for online learning, accessing forms and policies, and completing benefits enrollment.
• Language
  
  Skills:
  
  Working-level knowledge of the English language.

This position does not involve direct patient care. Telecommuting is allowed with approval from HIM Management. The role requires a commitment to meeting or exceeding productivity and quality standards defined by HIM Coding Leadership. The incumbent must stay informed about continual changes in Federal and State regulations.

Note:

The above description is not exhaustive and is intended to accurately reflect the general nature and level of the job.