Coding Auditor

You will be able to work from your home location within the Central and or Eastern United States

PURPOSE AND SCOPE:

Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record.

Validates abstracted data elements that are integral to appropriate payment methodology.  Provides feedback and education to coders.  Escalates compliance, risk-related issues to expedite mitigation. 

PRINCIPAL DUTIES AND RESPONSIBILITIES:


* Consults facility leaders and staff on best practices, methodology, and tools for accurately coding.


* Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures.

Adheres to Standards of Ethical Coding (AHIMA/AAPC).

Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures.  Reviews claim to validate abstracted data including but limited to discharge disposition which impacts reimbursement and/or MS-DRG assignment.  Adheres to Standards of Ethical Coding (AHIMA).
+ Reviews medical records to determine accurate required abstracting elements (facility/client/payer specific elements) including appropriate ESRD designation.

Reviews medical records for the determination of accurate assignment of all documented ICD-10 codes for diagnoses and procedures.


* Uses discretion, experience and specialized coding training to accurately assign ICD-10 codes to patient medical records.


* Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses and procedures.  Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by Fresenius policy.


* Reviews medical records to determine accurate required abstracting elements (clinic specific elements) including appropriate discharge disposition.


* Identifies and communicates documentation improvement opportunities and coding issues (lacking documentation, physician queries, etc.) to appropriate personnel for follow-up and resolution.


* Evaluates and prepares as indicated daily, weekly and monthly reports indicating quality levels and opportunities for charge capture and revenue maximization.  


* Monitors, prepares and presents reports including, but not limited to, Medical Record Delinquency Rates, Clinical Pertinence, H & P Compliance, Operative Note Compliance


* Develops and delivers education to horizontal and vertical audiences on coding and charge capture.


* Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10 coding.  Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-10 and CPT updates) for outpatient coding.  Quarterly review of AHA Coding Clinic.  Attends or facilitates Quarterly Co...