Hospital Coding Auditor

The Coding Auditor reviews/audits patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment, as applicable, according to established guidelines. This position issues the coding "report card" quarterly to all coders. This position provides coding training and education. This position may audit accounts for ER Charging accuracy and perform RAC and other third party audit appeals.

Responsibilities

Reviews patient records for correct ICD-10-CM/PCS codes, CPT Codes, POA assignment and MS-DRG assignment according to established guidelines and scores appropriately, if applicable. Works with CDIS on DRG assignment and educates on missed Query opportunities. Works with staff on coding guidelines and correct code assignment Informs manager of any activities which do not meet federal or state coding and billing requirements Appeals RAC DRG review charts. Receives requests from business office on issues relating to coding and responds within 5 working days, if possible. Reviews discharge summaries for coding accuracy. Assists in identification of potential identity errors. Coding Clinics are reviewed and applied appropriately.Assist in other duties as assigned to support the operational needs of the department and organization. May be required to remain on campus immediately before, during, and after severe weather and/or disasters.

Qualifications

Minimum Education

• Technical Diploma/Certificate Coding Required

Minimum Work Experience

• 5 years Inpatient and/or outpatient coding experience Required
• Experience in regulatory issues related to Medicare, and other third party payers as it relates to hospital and ambulatory coding and billing. Required

Licenses and Certifications

• Certified Coding Specialist (CCS_AHIMA) Required or
• Certified Professional Coder (CPC_AAPC) Required or
• Certified Coding Associate (CCA_AHIMA) Required

Company

Baptist Health Care is a not-for-profit health care system committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization includes three hospitals, four medical parks, Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. With more than 4,000 team members, Baptist Health Care is one of the largest non-governmental employers in northwest Florida.

Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC maintains and enforces a policy that prohibits discrimination against any workforce members or applicants for employment because of sex, race, age, color, disability, marital status, national origin, religion, genetic information, or other category protected by federal, state or local law. Certain positions may require a Level 2 Background check through AHCA. Additional information about this requirement can be found here: Florida Care Provider Background Screening Clearinghouse

Technical coding diploma required; 5+ years inpatient and/or outpatient coding experience; knowledge of ICD-10-CM/PCS, CPT, POA and MS-DRG; experience with Medicare and third-party payer regulations; CCS/CPC/CCA certification required.

Key Responsibilities

• reviewing records
• auditing codes
• providing training

Job Details

• Category: Finance and Accounting
• Seniority: Senior Level
• Commitment: Full Time
• Workplace: Remote — Pensacola, Florida, United States
• Languages: English

About Baptist Health Care

A not-for-profit health care system providing hospitals, medical parks, and a network of primary and specialty care providers in northwest Florida and south Alabama. — Industry: Healthcare