Job: EW CODING AUDITOR

EW CODING AUDITOR

Requisition Number: 28581

Location: NM - Albuquerque

Type of Opportunity: Regular Full-Time

FLSA Classification: EXEMPT

Minimum Experience: 1 year

Minimum Education: High School Degree or Equivalent

Shift: Days

* Liaison to the Manager, Information Services, Finance/Patient Financial Services, all hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and all ancillary departments in addressing functional coding, auditing, compliance and training issues and problems.

* Responsible for maintaining accurate, complete and timely documentation in either electronic or hard copy form.

* Maintains and disseminates up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area. This includes but is not limited to all ICD-9, CPT-4, HCPCS and APC updates and changes.

* Researches coding, billing and charging compliance issues, recommends and implements corrective action plans that assure compliance with regulatory agencies where appropriate.

* Responds to inquiries and requests daily regarding coding and auditing issues and problems and ad-hoc analysis for all PHS management.

* Maintains up-to-date working knowledge of all PHS coding and auditing IT applications.

* Gathers and analyzes information and provides recommendations to address and resolve business issues for a specific business group.

* Conducts training classes in areas of coding, documentation and compliance for PHS personnel. This includes preparation of training materials, educational audits and answering specific situational questions.

* Conducts systematic focused internal audits via medical record and charge ticket review to insure correct coding, billing and charging as member of Enterprise-Wide Coding audit team.

* Analyzes and summarizes data from medical record and account audits and communicate results and findings to management.

* Develops new methods and processes to improve coding efficiency and effectiveness.

* Ensures that coding functions are performed in accordance with established quality and performance standards by monitoring system generated reports and quality audits.

* Performs other functions as required.

Two to three years college level courses and one year healthcare coding, auditing or compliance related experience OR four years healthcare coding, auditing or compliance related experience. Required experience can include coding internship which provided specific on the job training in areas noted above. Must have any one of the following coding certifications at time of hire: CCS, CCA, CCS-P, CPC-A, CPC-H-A, CPC-H, CPC or RHIT/RHIA with achievement of coding credential within 12 months from date of hire . Excellent written and verbal communication skills. Detail and results oriented. Ability to work independently and make independent decisions. Medical terminology, ICD-9, CPT-4 and HCPCS knowledge required.