The Coding Compliance Auditor - Hospital, utilizing a strong coding background and clinical knowledge, will code diagnoses and procedures for admission and discharge claims in order to prevent loss of revenue, optimize charge capture, and adhere to all compliance standards. Assist with assigned special projects and audits that may include training and education.
The Coding Compliance Auditor- Hospital will consistently demonstrate support of the SRALAB statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute.
The Coding Compliance Auditor – Hospital will demonstrate SRALAB Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and SRALAB Values (Hope, Compassion, Discovery, Collaboration, & Commitment to Excellence) while fulfilling job duties.
Principal Responsibilities The Coding Compliance Auditor - Hospital will:
- Perform audits required by accrediting organizations to determine if the information in the medical records is meeting set standards and regulations as requested.
- Assist the compliance officer in assigned projects from internal or external sources.
- Perform assigned Medicaid, Medicare, and other third party payer audits.
- Code inpatient admission and discharged medical records within appropriate timeframes to meet timely billing requirements; assist in coding outpatient records as needed.
- Provide coding training and updates for coding team and other hospital staff as needed.
- Send queries for physicians to assist in accurate, quality documentation within the medical record.
- Review charge master updates and additions for appropriate current ICD-10 and CPT code assignment.
- Participate in communication and education with medical staff concerning documentation issues/queries to support accurate coding and billing.
- Supports continuous quality improvement efforts and performs special projects, training, education, and/or duties as assigned by the Director of Medical Records.
- Perform all other duties that may be assigned in the best interest of the Shirley Ryan AbilityLab.
- Report directly to the Director, Medical Records
Knowledge, Skills & Abilities Required
- Coding Certification through AHIMA or AAPC for inpatient or Outpatient coding. (i.e., RHIA, RHIT, CCS, or CCS-P certification) and maintains continuing education requirements.
- 1-2 Years of ICD-10 and CPT coding experience and clinical knowledge minimally.
- Knowledge of regulatory, billing, and other coding guidelines.
- Thorough knowledge of related prospective payment systems.
- Auditing skills for coding quality and compliance.
- Advanced computer skills, PC-experience with Windows based applications.
- Interpersonal skills necessary to effectively communicate with other departments, physicians, outside agencies, and key customers. Good writing skills to create reports and ability to graphically present audit data. The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
SRAlab is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
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