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Now viewing: Coding Auditor
DO
Desert Oasis Healthcare
Coding Auditor
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Job Description
The Coding Auditor is responsible for reviewing documentation and medical records to ensure accurate coding of services and diagnosis. This role will collaborate with providers to improve clinical documentation and ensure compliance with governmental and regulatory requirements. Professional Duties Serve as a resource and subject matter expert for the coding team and providers to ensure the highest level of coding and documentation specificity. Complete annual provider documentation validation audits, which includes but is not limited to: record requests, documentation review, provider report cards, and management reports. Complete concurrent chart review for assigned providers. Report findings to department management and appropriate provider. Collaborate with departmental management to coordinate Health Plan and Risk Adjustment Data Validation (RADV) audits to validate the accuracy of coding submitted by provider. Share results with departmental management and attend meetings with Health plans to discuss audit results. Complete monthly prevalence review for targeted HCC categories and providers. Presents individualized results to each Provider, as necessary. Utilize various reports to validate codes, ensure accurate data submission, and submit corrections if necessary. Manage all aspects of assigned coding projects. Collaborate on coding project tasks as needed. Escalate concerns/issues to department management. Perform other duties as assigned. Help others, offering to assist (Ask, how may I help you?) Do your share. Do what you say you will do and take action, follow through. Be willing to pitch in and help Assume a neutral position and suspend judgment of others Be accountable for your work Demonstrate appropriate body language and tone of voice Speak positively about your work, co-workers and Desert Oasis Healthcare and Family Hospice Care See the positive in situations and in others Avoid gossip and negativity Qualifications High school or equivalent and Completion of a formal Coding Program required. Current AHIMA or AAPC coding certification (CCS, CCS-P, CPC, CCA) and current AHIMA or AAPC Risk Adjustment Certification (RAC or CRC) Additional specialty coding certifications (CPMA, CDEO or CDIP) preferred. 3 years of coding experience that encompasses documentation audits and Risk Adjustment (HCC) required. Knowledge of diagnosis codes, HCC categories and CMS documentation guidelines. Ability to utilize Microsoft Office Suite applications/software (Word, Excel, Power Point, Excel). Ability to communicate effectively with individuals within all levels of the organization, patients, providers, vendors and others. Ability to manage time effectively and prioritize tasks to meet established deadlines. At the discretion of the