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PRN Outpatient Audit Specialist
Ciox Health

Location: REMOTE, Remote
Work Setting: Consultant/Vendor
Job Function:
Auditor
Job Type:
Part-Time

Introduction

PRN Outpatiend Facility Coding Auditor

Job purpose

 

The Auditing Specialist will respond to consulting and education needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management and coding workflow operations reviews.  Offer meaningful information to meet customer expectations including identifying and proposing solutions for customer issues. Develop and maintain account relationships through responsiveness and calm, reflective work practices.  Work cooperatively with the Data Quality & Coding Compliance leadership and scheduling for optimal services outcome.

Job Description

Duties and responsibilities

  • Performs inpatient and outpatient coding audits medical records and abstracts using ICD-10-CM CPT and appropriate coding references for appropriate DRG and APC assignment.
  • Reviews non-CC/MCC records to determine if record was properly coded or if additional

documentation is needed. Reviews all HCPCS and CPT codes impacting APC assignment

  • Provides coder education via the auditing process
  • Prepares preliminary results for review by the facility or CCS HIM director
  • Reviews APC/DRG change disagreements with appropriate manager
  • Prepares the final reports for the coding audit. Participates in settlement of audit findings.
  • Provides coder education via email and/or conference call using the audit spreadsheet findings and comments
  • Attends coding workshops as necessary
  • Keeps abreast of regulatory changes
  • Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
  • Shows versatility and exemplary work including a wide range of services coded
  • Meets with client facility representatives to discuss issues and trends identified in audit
  • Develops and implements education for physician, nursing, and other clinical staff to improve documentation
  • Demonstrate initiative and judgment in performance of job responsibilities
  • Communicates with co-workers, management, and hospital staff regarding clinical and reimbursement issues
  • Function in a professional, efficient and positive manner
  • Adhere to the American Health Information Management Association’s code of ethics
  • Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
  • Audits external coding staff as needed and provides reports to manager as directed
  • High complexity of work function and decision making
  • Strong organizational, teamwork, and leadership skills
  • LOCATION: This job is fully remote 

    TYPE: Part-time (PRN, hours may vary)

Required Qualifications

Duties and responsibilities

  • Performs inpatient and outpatient coding audits medical records and abstracts using ICD-10-CM CPT and appropriate coding references for appropriate DRG and APC assignment.
  • Reviews non-CC/MCC records to determine if record was properly coded or if additional

documentation is needed. Reviews all HCPCS and CPT codes impacting APC assignment

  • Provides coder education via the auditing process
  • Prepares preliminary results for review by the facility or CCS HIM director
  • Reviews APC/DRG change disagreements with appropriate manager
  • Prepares the final reports for the coding audit. Participates in settlement of audit findings.
  • Provides coder education via email and/or conference call using the audit spreadsheet findings and comments
  • Attends coding workshops as necessary
  • Keeps abreast of regulatory changes
  • Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
  • Shows versatility and exemplary work including a wide range of services coded
  • Meets with client facility representatives to discuss issues and trends identified in audit
  • Develops and implements education for physician, nursing, and other clinical staff to improve documentation
  • Demonstrate initiative and judgment in performance of job responsibilities
  • Communicates with co-workers, management, and hospital staff regarding clinical and reimbursement issues
  • Function in a professional, efficient and positive manner
  • Adhere to the American Health Information Management Association’s code of ethics
  • Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
  • Audits external coding staff as needed and provides reports to manager as directed
  • High complexity of work function and decision making
  • Strong organizational, teamwork, and leadership skills
  • LOCATION: This job is fully remote 

    TYPE: Part-time (PRN, hours may vary)

Instructions for Resume Submission

Apply online:

https://careers-cioxhealth.icims.com/jobs/13766/prn-outpatient-audit-specialist/job

 

Questions: allison.salud@cioxhealth.com

Apply Online: https://careers-cioxhealth.icims.com/jobs/13766/prn-outpatient-audit-specialist/job

Posted: July 22, 2020 at 5:56 PM
Post ID: 52637

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