Inpatient Coder with Auditing Experience - Remote

Overview

The Inpatient Coder with Auditing Experience is responsible for reviewing inpatient medical records, assigning accurate codes to diagnoses, procedures, and treatments, and ensuring compliance with healthcare regulations. This role also involves conducting audits to assess coding accuracy, identify discrepancies, and ensure proper billing procedures are followed.

In Short

• Review Medical Records: Examine inpatient records thoroughly to assign appropriate ICD-10-CM, CPT, and HCPCS codes for diagnoses, procedures, and treatments rendered during a patient’s stay.
• Assign Accurate Codes: Apply accurate and complete ICD-10-CM, CPT, and HCPCS codes, ensuring they are in compliance with all legal and regulatory standards, including CMS guidelines.
• Auditing: Conduct regular audits of coded medical records to ensure coding accuracy, identify errors, and recommend corrections. Document and report audit findings.
• Error Identification & Resolution: Identify discrepancies in coding, billing, and documentation, working with the healthcare providers to resolve any issues, improve coding accuracy, and maintain compliance.
• Provide Feedback and Training: Offer feedback to physicians, clinical staff, and coding teams regarding coding errors or omissions. Assist in training staff on proper coding practices.
• Compliance with Regulations: Ensure all codes meet CMS, HIPAA, and other regulatory standards, staying updated with any changes to coding systems, medical laws, and regulations.
• Claim Submission: Support the billing department in ensuring that all medical claims are accurately coded and submitted to insurance companies in a timely manner.
• Documentation Quality: Ensure the completeness and accuracy of documentation for reimbursement purposes, and that it meets payer requirements.
• Prepare Reports: Generate and present detailed audit reports outlining audit results, code discrepancies, and improvement opportunities.
• Continuous Learning: Keep current with new coding practices, medical terminology, changes in payer guidelines, and other developments in healthcare coding and auditing.

Requirements

• Education: High school diploma or equivalent; Associate's degree in Health Information Technology, Medical Coding, or a related field is preferred.
• Certifications: Certification as a Certified Inpatient Coder (CIC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS) from organizations like AAPC or AHIMA. A certification in coding auditing (e.g., Certified Coding Auditor (CCA)) is a plus.
• Experience: At least 3-5 years of experience as a medical coder, with a strong focus on inpatient coding and experience in coding audits.
• Technical Skills: Proficient in coding software (e.g., 3M), Electronic Health Records (EHR) systems, and Microsoft Office Suite.
• Knowledge: Thorough understanding of medical terminology, anatomy, physiology, ICD-10-CM, CPT, HCPCS coding systems, and insurance claim processing. In-depth knowledge of auditing processes and guidelines.
• Analytical Skills: Strong analytical abilities to detect coding errors, discrepancies, and audit irregularities.
• Attention to Detail: Excellent attention to detail, ensuring accuracy and compliance in coding and documentation.
• Communication Skills: Ability to communicate effectively with clinical staff, healthcare providers, and insurance companies, and to provide constructive feedback.

Benefits

• Details about benefits are not provided in the job description.