Healthcare Coding Compliance Auditor - RUHS MC

Riverside University Health System (RUHS) is seeking a skilled Coding Compliance Auditor (Administrative Services Manager I) to support the Compliance Department.

The Compliance Auditor will review inpatient and outpatient medical records to ensure quality, accuracy, and comprehensive coding in accordance with regulations.
Key Responsibilities:


* Conduct thorough reviews of medical records for compliance with coding regulations


* Provide feedback and education to coders and physicians to improve coding accuracy and documentation


* Perform annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested


* Communicate effectively with all RAC stakeholders, ensuring timely and accurate responses to inquiries


* Support ongoing program development through training initiatives and process improvements


* Deliver coding presentations to diverse audiences, including physicians


* May supervise departmental staff as needed

Qualifications:


* Minimum of five (5) years' experience coding inpatient and/or outpatient hospital records using ICD-10, CPT, HCPCS, and other third-party payor codes


* At least two (2) years of lead or supervisory experience


* Certified Professional Medical Auditor (CPMA) certification preferred


* Strong organizational and communication skills, comfortable interacting with physicians and various stakeholders

Work Schedule & Location:


* Schedule: 9/80 work schedule


* Location: 7898 Mission Grove Parkway, Riverside

Why RUHS Medical Center?
Riverside University Health System-Medical Center is nationally recognized for its innovative, progressive care and is considered one of the top employers in the region.

The 439-bed Medical Center is a designated Stroke Center, Level I Trauma Center, and home to the only Pediatric ICU in the area.

Can you see yourself here? For more information about RUHS Medical Center, please visit www.ruhealth.org .Establishes implements and maintains a review process for coding/CDI compliance, including a formal review (audit) process.

Reviews inpatient and/or outpatient coded records for quality and comprehensive coding and documentation to ensure compliance with ICD-10-CM, CPT4, and HCPCS level II coding conventions.

Analyzes and interprets coding data to identify problems or trends.

Ensures compliance with clinical documentation Integrity, coding standards and government regulations.

Maintains knowledge of coding and billing requirements and regulatory changes.

Assists in the ongoing development and maintenance of a coding/abstracting policies, procedure and practice standards.

Audits, reports and documents all results to the Compliance officer utilizing spreadsheet/software algorithms as necessary.

Provides, initiates, and supports training/education for the coding and compliance regulations to all RUHS staff as needed.

Creates videos and educational modules on updates as required.
Supports the educatio...