CRC​/DRG Coding Auditor - Remote

JOB SUMMARY

Conducts data quality audits of inpatient admissions and 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.

• Consults facility leaders and staff on best practices, methodology, and tools for accurately coding.
• Charts Analysis:
  Reviews medical records to determine accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews claim to validate abstracted data including discharge disposition which impacts facility reimbursement and/or MS-DRG assignment.
• Coding:
  Uses discretion and specialized coding training and experience to accurately assign ICD-9, CPT-4 codes to patient medical records.
• Abstracting:
  Reviews medical records to determine accurate required abstracting elements with appropriate discharge disposition.
• Coding Quality:
  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 SOW.
• CDI:
  Identifies and communicates documentation improvement opportunities and coding issues to appropriate personnel for follow-up and resolution.
• Professional Development:
  Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-9-CM and CPT coding. Attends mandatory coding seminars annually (IPPS and OPPS, ICD-9-CM and CPT updates) for inpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls.

This position carries out supervisory responsibilities in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

• Ability to consistently code at 95% accuracy and quality while maintaining client specified production standards.
• Must successfully pass coding test.
• Knowledge of medical terminology, ICD-9-CM and CPT-4 codes.
• Must be detail oriented and have the ability to work independently.
• Computer knowledge of MS Office.
• Must display excellent interpersonal skills.
• The coder should demonstrate initiative and discipline in time management and assignment completion.
• The coder must be able to work in a virtual setting under minimal supervision.
• Intermediate knowledge of disease pathophysiology and drug utilization.
• Intermediate knowledge of MSDRG classification and reimbursement structures.
• Intermediate knowledge of APC, OCE, NCCI classification and reimbursement structures.

• Associates degree in relevant field preferred or combination of equivalent of education and experience.
• Three years coding experience including hospital and consulting background.

• RN.
• AHIMA and/or AAPC approved credentials.

• Duties may require bending, twisting and lifting of materials up to 25 lbs.
• Duties may require driving an automobile to off- site locations.
• Duties may require travel via plane, care, train, bus, and taxi-cab.
• Ability to sit for extended periods of time.
• Must be able to efficiently use computer keyboard and mouse to perform coding assignments.
• Capacity to work independently in a virtual office setting or at hospital setting if required to travel for assignment.

• Floats between clients as requested.

• Regular travel may require (not)

Pay: $67,371 - $101,088 annually. Compensation depends on location, qualifications, and experience. Management level positions may be eligible for sign-on and relocation bonuses.

Benefits: Conifer offers the following benefits, subject to employment status:
Medical, dental, vision, disability, life, and…