Outpatient Coding Quality Auditor
1 week ago
iMedX, a RapidCare Group company, is seeking a part-time Outpatient Coding Consultant with extensive expertise to provide advisory services on coding cases. This position allows for remote work, with the possibility of transitioning to full-time 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 Coding Guidelines, iMedX protocols, and relevant facility standards. The role involves reviewing facility documentation for the accuracy and completeness of APC-reimbursed ICD-10-CM and CPT coding assignments.
Reporting Structure: This position reports directly to the Core Measure and Registry Manager.
Primary Responsibilities:
- Analyze pertinent clinical information from health records with an emphasis on accurate coding assignments.
- Determine principal and secondary diagnoses in accordance with Outpatient Coding Guidelines.
- Assign ICD-10-CM codes to both primary and secondary diagnoses.
- Identify procedures following 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, employing effective time management and professional practices while meeting productivity benchmarks.
- Timely refer coding inquiries to a manager or designated individual for guidance and development of coding guidelines.
- Continuously improve coding competencies by participating in team meetings and educational sessions to keep coding practices up-to-date.
- Ensure confidentiality and protect the privacy of all protected health information (PHI).
- Uphold the values of the Company.
- Execute additional job-related tasks as assigned or required.
Qualifications: Completion of a recognized coding program is required. Preferred credentials include Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or other coding certifications approved by AHIMA or AAPC.
Experience: A minimum of five years of coding experience is required, including at least two years in coding review and coder education. Candidates should possess a solid 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. Candidates must have Windows 11 and high-speed internet access.
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