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Professional Coding Auditor

Expired Job

El Camino Hospital Mountain View , CA 94035

Posted 4 months ago

  • The Professional Coding Auditor conducts complex audits for clinic based providers to ensure selected coded data, Evaluation and Management, and charge assignments are compliant with Official Coding Guidelines in ICD-10-CM coding conventions and CPT/HCPCS coding conventions. The role of the auditor is to educate physicians to ensure that data within the legal medical record is coded efficiently and accurately for appropriate reimbursement and medical necessity to meet regulatory accreditation requirements for state and federal reporting.

    Acts as liaison and works in conjunction with Patient Financial and Revenue Cycle teams to ensure coded data meets the national standards through collaborative discussion and with direct physician education. Provides physician specific education based on the quality monitoring of claim denials and trends. Reconciles hospital base admissions for surgical charge-entry with appropriate CPT and modifier assignments in conjunction of global days in mitigating claim denials and unbundle reporting. Participates in clinic base onsite training and meetings at various clinic locations and provides general coding coverage and other duties when necessary.

QUALIFICATIONS:
1.College level coursework in ICD-10-CM and CPT coding, anatomy and physiology, and medical terminology
2.Minimum of three years' experience in auditing and claim denial reviews in acute clinic and hospital setting
3.Strong training background in outpatient clinic setting with direct 1:1 physician education, preferred
4.Minimum five years' experience of coding and demonstrating knowledge in the principals and practices of ICD-10-CM and CPT conventions with clinic visits and hospital surgical coding.
5.Strong communication both oral, written and organizational skills
6.Proficiency with Excel, Word, and Outlook
7.Demonstrated ability to work productively, accurately, and independently
8.Proven analytical and problem solving skills in compiling statistical data and state reporting
9.Comprehensive mastery of APC assignment methodology with emphasis in NCCI edits
10. Ability to interact well with all levels of employees and physicians throughout the organization, participate in intra- and interdepartmental collaboration, and handle multiple tasks concurrently to meet deadlines.
11. Technical aptitude for resolving basic PC hardware and software application problems and ability to perform basic troubleshooting

License/Certification/Registration Requirements
1.Certified Professional Coder (CPC)
2.AHIMA Certified Coding Specialist (CCS) credential, preferred



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Professional Coding Auditor

Expired Job

El Camino Hospital