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Position Summary:

Responsible for working with physicians, coders, ancillary department staff, Clinical Documentation Improvement (CDI), and other allied health professionals to improve documentation of patient care and appropriately assign codes and/or determine charges to support those services.

Essential Functions and Responsibilities As Assigned

:

1. Responsible for completing quality assurance audits on professional coding specialists, onboarding audits and training of newly hired coding specialists, validating the coding specialist is accurately abstracting data into medical record systems, following coding guidelines, and relevant federal and other pertinent materials.

2. Optimizes prospective payment reimbursement and facilitates data quality by creating consistency and efficiency in physician documentation, code assignment, data collection, and claims processing.

3. Performs retrospective, random, and focused audits of coding cases to ensure correct coding, legal compliance, and complete charge capture.

4. Evaluates the proper assignment of procedure, modifier, and diagnosis codes to professional services to validate accuracy and compliance.

5. Reports quality results, tracking and trending of educational opportunities of the coding specialist and provides educational support and training.

6. Gathers, transfers, and analyzes all auditing results to capture and demonstrate risk issues, revenue leakage and educational opportunities.

_Required:_

* Associate degree in HIT, Applied Science, Liberal Arts or related healthcare field

* 1 year evaluation and management (E&M) coding experience in any medical specialty

* 3

years’ experience in surgical and outpatient procedural coding is required.

* Certified in at least one of the following:

+ AHIMA Certification (such as: RHIA, RHIT, CCS)

+ AAPS Certification (such as: CPC, CCS-P, CCC, COC, CIC, CHONC, etc.)

AMAC Certification such as ROCC (Radiation Oncology Certified Coder)

_Preferred:_

* _1 year audit experience_