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Reference # : 14-00124 Title : Coding Auditor/Trainer
Category: Health Information Management
Location : Whittier
Position Type : Direct Placement
Experience Level : 3 Years Start Date : 01/30/2014  
Health System that has multiple hospitals/medical groups in Southern California. They are expected to grow within the next several years, while acquiring other hospitals and medical groups.

Coding Auditor/Trainer

  • Responsible for auditing health records to determine whether the code assignment is substantiated by provider documentation for inpatient and ambulatory hospital based encounters.
  • Analyzes data from PEPPER and ICD-10 reports to identify trends and educational opportunities. Develops and presents coding and documentation education materials concerning ICD-9 CM, ICD-10 CM and PCS, CPT, HCPCS, APC, DRG and coding guidelines to clinical, HIM coding, clinical documentation integrity and medical staff.
  • Safeguards and preserves the confidentiality of patient's protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies.
  • Ensures a safe patient environment and adherence to safety practices per policy.
  • With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care.
  • Performs coding quality reviews on inpatient and ambulatory hospital based encounters to validate appropriate code assignment of diagnoses and procedures.
  • Prepares monthly quality and productivity statistics for coding staff.
  • Communicates with co-workers, management, and hospital staff regarding clinical documentation and reimbursement issues.
  • Provides on-going training to the coding staff based on quality findings and regulatory changes.
  • Validates appropriate abstracting elements are captured on inpatient and ambulatory encounters.
  • Consults collaboratively with physicians to obtain clarification of diagnoses, treatment, reason for admission, etc.
  • Provide coding assistance and feedback to ensure appropriate reimbursement and accurate coding.
  • Refers coding and system questions to the coding supervisor and/or manager in a timely manner for resolution.
  • Assists the Business Office staff in correction of coding related edits.
  • Provides training to contract coding staff, new coding staff and coding staff transitioning to other work types.
  • Performs other related duties as assigned or directed.
  • Abides by and strongly enforces all compliance requirements and policies and performs his/her responsibilities in an ethical manner consistent with the organizations value.
  • Participates in the development of coding and abstracting policies and procedures.
  • Current American Health Information Management Association (AHIMA) certification as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) or Certified Coding Specialist (CCS) is required.
  • An Associate of Science or Bachelor of Science degree in Health Information from an approved AHIMA program is preferred.
  • One-year experience in coding auditing in an acute hospital setting or experience with education/training in ICD- 9CM, CPT, and reimbursement methodologies.
  • AHIMA approved ICD-10 trainer certificate preferred.
  • Knowledge of clinical documentation integrity and experience using a computerized abstracting system is preferred.
  • Experience in analysis of coded data and presentation of findings required.
  • Demonstrates expert technical knowledge of ICD-9-CM disease and procedural coding, CPT-4 and HCPCS procedural coding.
  • Must have a thorough knowledge of anatomy and physiology and medical terminology.
  • Knowledge of Office of Statewide Health Planning and Development (OSHPD) and Uniform Hospital Discharge Data Set (UHDDS) required.
  • Knowledge of Case Mix Index required.
  • Familiarity with computers, and encoding software and the general principles of medical record science is preferred.
  • Use of Excel spreadsheet program is required.
  • A high level of professionalism and effective communication skills is needed for interaction with physicians, physician office staff, hospital staff, patients and hospital visitors.
Salary up to $90,000 with exceptional benefits

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