Audit Specialist

Employer: Ciox Health

Overview

The Auditing Specialist will respond to consulting and education needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management and coding workflow operations reviews. Offer meaningful information to meet customer expectations including identifying and proposing solutions for customer issues. Develop and maintain account relationships through responsiveness and calm, reflective work practices. Work cooperatively with the Data Quality & Coding Compliance leadership and scheduling for optimal services outcome.

Details:

• PRN: Flexible Schedule
• Location: Remote/Work from home
• Required: A minimum of 3 years of OP coding or auditing experience.
• Preferred: CCS, RHIT, or RHIA credentials.
• Preferred: Recent academic medical center or level I trauma center auditing experience.

We Offer:

• Full Benefits: 401k Savings Plan
• 20-24 free CEUs per year, provided by Ciox
• AAPC/AHIMA dues compensation
• Company equipment will be provided to you (including computer, monitor, etc.)
• Comprehensive training lead by a hiring manager

Responsibilities

• Performs inpatient and outpatient coding audits medical records and abstracts using ICD-10-CM CPT and appropriate coding references for appropriate DRG and APC assignment.
• Reviews non-CC/MCC records to determine if record was properly coded or if additional
• documentation is needed. Reviews all HCPCS and CPT codes impacting APC assignment
• Provides coder education via the auditing process
• Prepares preliminary results for review by the facility or CCS HIM director
• Reviews APC/DRG change disagreements with appropriate manager
• Prepares the final reports for the coding audit. Participates in settlement of audit findings.
• Provides coder education via email and/or conference call using the audit spreadsheet findings and comments
• Attends coding workshops as necessary
• Keeps abreast of regulatory changes
• Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
• Shows versatility and exemplary work including a wide range of services coded
• Meets with client facility representatives to discuss issues and trends identified in audit
• Develops and implements education for physician, nursing, and other clinical staff to improve documentation
• Demonstrate initiative and judgment in performance of job responsibilities
• Communicates with co-workers, management, and hospital staff regarding clinical and reimbursement issues
• Function in a professional, efficient and positive manner
• Adhere to the American Health Information Management Association’s code of ethics
• Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
• Audits external coding staff as needed and provides reports to manager as directed
• High complexity of work function and decision making
• Strong organizational, teamwork, and leadership skills

Qualifications

• Minimum of 3 years experience coding or auditing
• CCS and RHIA or RHIT credentials preferred
• Recent experience in academic/level 1 trauma centers
• Experience coding or auditing inpatient and outpatient records for various facilities
• Track record of acceptable productivity standards
• Maintain 95% accuracy rate for APC assignment and 95% productivity rate
• Experience with various software including EMR, Encoder and Auditing software

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