Coding Auditor

OSF Healthcare • Peoria, IL, United States • $200k - $250k / year • 1m ago

Overview:

Pay range for this position is $26.46-$31.13; Actual pay will be determined by experience, skills and internal equity.

POSITION SUMMARY: The Coding Auditor is responsible for performing coding and documentation reviews to ensure the quality and integrity of coding data captured for OSF services. Provides validation of accurate and compliant coding and charging to ensure adherence to established coding guidelines of ICD-10, CPT, governmental and third-party payers; ensuring coding quality standards are achieved and maintained. Responds to external coding audits and DRG billing denials, writing appeals, documenting coding rationale and defending OSF coded data based on provider documentation and coding rules and conventions as appropriate. Researches coding and/or billing code requirements using encoders and various professional and government publications in order to achieve compliance and optimize reimbursement. Participates in productive coding workflows to maintain up-to-date knowledge of current documentation and coding software toolset.

REQUIRED QUALIFICATIONS:

Education: Associates Degree in Health Information Management OR Bachelors Degree in an applicable health-related field.
Licensure/Certifications: Must have one of the following certifications: RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician), CCS (Certified Coding Specialist), CMA (Certified Medical Office Assistant), CPC (Certified Professional Coder) OR must obtain AHIMA- CCS certification within 12 months of hire.
Experience: 3 years of experience in hospital or professional coding.
Other skills/knowledge: Advanced knowledge of ICD10-CM/PCS and CPT/HCPCS coding guidelines; knowledge of medical terminology, anatomy/physiology, disease processes, medical records, and hospital procedures; ability to concentrate on a task over a period of time without being distracted; basic keyboard and software application skills, including Electronic Medical Record systems; demonstrated ability to communicate effectively via written and verbal means; demonstrated excellent professional writing skills; analytical skills necessary in collecting, analyzing, and reporting departmental quality indicators ensuring compliance with regulatory data requirements, establishing coding area goals, and assessing outside coding review activities.

PREFERRED QUALIFICATIONS: Fluency with advanced understanding of both MS and APR DRG methodologies; direct experience with chart quality audits and/or denial response writing.

OSF HealthCare is an Equal Opportunity Employer.

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