Job Description:

POSITION SUMMARY

The HIM Coding Auditor is responsible for supporting the HIM Division by conducting internal and external coding related audits. This position will perform client-based coding quality audits and post assessments (quality control audits). The Auditor serves as a resource for internal and external customers.

RESPONSIBILITIES

  • Perform internal and external coding audits and communicate feedback to coders to correct errors and improve skill
  • Ensure all HIM Consultants meet 95% or better accuracy and productivity standards as outlined in the HIM Compliance & Audit Plan and as applicable for the client they are supporting
  • Coordinate with the Compliance and Audit Manager to perform education, action plans, or other measures necessary to assist those who are falling below the minimum 95% standard or are not meeting productivity standards
  • Maintain expected productivity metrics for performing audits as outlined in the annual goals and objectives
  • Notify Compliance & Audit Manager of any concerns regarding attendance, communication or general performance of any consultants within an audit
  • Provide external education which include on-site education or web-based in-service sessions
  • Assist and support Recruiters for further investigation of a Consultant’s skills as required for the prospective job submission
  • Attend and train client trainings for onboarding and orientation of consultants on new assignments
  • Act as point of contact to disseminate instructions and communications from the clients to the Consultants regarding policies, processes and productivity expectations
  • Ensure all processes and policies are clearly documented and approved by client
  • Facilitate issue resolution in conjunction with the Engagement Manager any issues escalations

QUALIFICATIONS

  • RHIA, RHIT, CCS or CPC required
  • 3+years of auditing experience
  • Thorough working knowledge and demonstrated experience in both MS-DRGs, APR-DRGs, and APC’s required
  • Proficiency in the following code sets required: ICD-10-CM, ICD-10-PCS, CPT and professional services E&M coding.
  • Working knowledge of state and federal regulations regarding fraud and abuse laws required
  • Excellent verbal and written communications skills is a must
  • Ability to multitask in a fast-paced environment
  • Solid analytical and problem-solving skills
  • Proven knowledge of MS Office products