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Coding Auditor
- New York, New York, United States
- New York, New York, United States
Über
Experienced coder who has participated in Regulatory Audits (RADV and HRADV) Reviews patient records in accordance with current compliance policies to analyze provider documentation to ensure that it meets standards and supports the diagnosis and procedure codes selected, including supporting medical necessity severity of illness and risk of mortality Conduct audits on abstracted files to ensure accuracy and completeness of coding by identifying accurate coding opportunities and rechecking all diagnoses and procedures using ICD-CM (ICD-9 and ICD-10) and CPT-4 codes to ensure adherence to all official coding guidelines, federal and state regulations, health system and departmental policies and productivity standards. Demonstrates an understanding of hierarchical condition categories (HCCs) and participates in quality coding initiatives as appropriate or assigned. Ability to clearly communicate coding findings
Required Skills and Experience
Assoc degree and 3 yrs RADV experience. In lieu of degree, 5 yrs relevant experience. Proficient knowledge of CMS-HCC model and guidelines Previous experience in auditing medical records Coding Certification required (CRC, RHIA, RHIT or similar) in good standing ICD-10 proficient
Preferred Skills and Experience
Bachelor's Degree Experience with NLP/AI coding software Risk Adjustment methodology experience Specialty coding experience
Sprachkenntnisse
- English
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