Outpatient Coding Auditor

Purpose and Scope:
The incumbent is responsible for management and supervision of VHC Physician Practice coding staff. In addition the position also requires performing in-depth reviews of acute-care hospital Outpatient medical records to ensure HCPCS/ CPT-4 codes and APC assignments are valid and supported by clinical documentation. Major responsibilities include the performance of internal billing, charging and coding audits and record reviews as part of the hospital's compliance program, planning and coordination of internal outpatient coding audits, monitoring staff for coding guideline compliance, educating and training coding and medical staff on all data quality and documentation issues, including APC developments. The incumbent also assists in developing outpatient coding policies and procedures and revising existing ones for the coding section. Strong interpersonal skills and excellent judgment are required. The incumbent serves as back up to the Clinical Reimbursement Manager when necessary.
Position Requirements:
A. Education:
Certification as Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) or Certified Coding Specialist-Physician based (CCS-P) required.
B. Experience:
A minimum of five years hands-on experience using the current coding classification systems in a health information management department required. Extensive knowledge of CPT, HCPCS and APC systems, encoders and groupers, and internet-based coding systems is essential. A thorough understanding of compliance regulations, audit procedures, quality improvement activities, project management and data collection is essential. Excellent written, oral and computer skills a must.

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