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Outpatient Coding Quality Auditor
2 months ago
iMedX, a RapidCare Group company, is seeking a part-time Outpatient Coding Consultant with a robust background in coding to handle advisory cases. This position is remote, allowing for flexibility in your work environment. There is potential for this role to evolve into a full-time opportunity based on client requirements and operational considerations.
Objective
The Outpatient Coding Consultant is responsible for examining clinical data from health records and conducting audits to ensure precise and comprehensive ICD-10-CM and CPT-4 coding in line with Official Guidelines for Coding and Reporting, as well as iMedX and facility-specific protocols. This role includes reviewing facility documentation for the accuracy and completeness of APC-reimbursed ICD-10-CM and CPT coding assignments.
Reporting Structure: The Outpatient Coding Consultant will report directly to the Core Measure and Registry Manager.
Primary Duties:
- Analyze pertinent clinical information from health records with an emphasis on accurate coding assignments.
- Determine principal and secondary diagnoses following Outpatient Coding Guidelines.
- Assign ICD-10-CM codes to both primary and secondary diagnoses.
- Identify procedures based on Outpatient Coding Guidelines.
- Validate ICD-10-CM diagnosis codes and CPT procedure codes assigned by the facility.
- Adhere to Clinical Coding Initiative (CCI) edits when assigning CPT-4 codes.
- Conduct coding reviews efficiently while maintaining productivity standards.
- Timely refer coding inquiries to a manager or designated individual for guidance and development of coding guidelines.
- Continuously improve coding expertise by participating in team meetings and educational sessions to stay updated on coding practices.
- Ensure confidentiality and protect the privacy of all protected health information (PHI).
- Uphold the values of the company.
- Perform additional job-related tasks as required.
Qualifications: Completion of a formal coding program is required. Preferred credentials include Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or other AHIMA or AAPC recognized coding certifications.
Experience: A minimum of five years of coding experience is necessary, including at least two years in coding review and coder education. Candidates should possess a comprehensive understanding of ICD-10-CM and CPT coding systems, medical terminology, anatomy and physiology, and health record content. Proficiency in coding various record types, including outpatient (ER, diagnostic, injections/infusions, or observations) and ambulatory surgery, is essential. A Windows 11 operating system and high-speed internet connection are required.
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