Inpatient Coding Auditor

The Inpatient Coding Auditor is a seasoned auditor and certified professional coder with extensive expertise in inpatient coding and auditing across various specialties. Your primary focus will be to ensure coding accuracy and compliance at the highest standards, crucial for maintaining data integrity and reimbursement. You will need advanced knowledge of MS and APR grouping methodologies, exceptional attention to detail, and effective collaboration skills with internal teams to drive continuous improvement in coding practices. Performing data analytics on coded data will be essential to identify trends and patterns in coding errors. Collaborating with internal staff is a key responsibility to enhance documentation, coding, and compliance. You will review and assess coding quality on accounts completed by Medical Coders, ensuring that clinical documentation supports the codes assigned and meets necessary standards. Adherence to workflows and ethical coding standards is mandatory. Utilizing your advanced knowledge of ICD-10-CM and ICD-10-PCS coding concepts, you will communicate review findings and recommendations to management, assess risk, and gather necessary statistics for coding areas. Administering the Quality Monitoring Program to meet quality standards and targets, managing daily operational processes for quality, efficiency, and productivity, and utilizing data analytics to proactively address coding errors are vital duties. Collaborating with workgroups, seeking continuous improvement opportunities, and staying updated on guideline changes and regulations impacting documentation and reimbursement are essential tasks. Participating in performance improvement activities, establishing a formalized review process for compliance, recommending strategies for high compliance with quality management plans, and providing feedback to management on improvement areas are key responsibilities. Demonstrating exceptional attention to detail, accuracy in reviewing medical records, and using protected health information (PHI) in accordance with HIPAA standards are crucial. Compliance with Med-Metrix policies, identifying high-risk areas in coding, and providing feedback for potential problems are also part of your role. Qualifications: - Hold AAPC and/or AHIMA certification, CPMA being advantageous - 3-5 years of Coding and auditing experience - Knowledge of HIPAA in Medical Coding - Proficiency in Microsoft Office Suite - Strong problem-solving skills and ability to communicate effectively at all levels - High level of integrity, dependability, and customer service orientation Working Conditions: Physical Demands: Occasional movement around the work area, manual tasks, operation of office equipment, extending arms, kneeling, talking, and hearing. Mental Demands: Ability to follow directions, collaborate, and handle stress. Work Environment: Minimal noise level in the work environment.,