Coding Auditor

At Methodist Hospitals, we are seeking a skilled Coding Auditor to join our team. As a Coding Auditor, you will play a critical role in ensuring the accuracy and quality of coding assignments for all records requiring DRG and/or APC coding.

• Perform comprehensive pre-billing coding audits to ensure claims are accurately coded and charged in compliance with coding and regulatory standards.
• Conduct data quality reviews on inpatient and/or outpatient records to ensure proper coding guidelines have been followed and appropriate DRG (MS/APR) or APC assignments have been made for appropriate reimbursement.
• Maintain an audit response turnaround time of 24 to 48 hours, with the exception of weekends.
• Review abstracted data to ensure quality of required data elements, including appropriate discharge disposition.
• Serve as a subject matter expert on ICD 10-CM/PCS and/or CPT/HCPCS coding guidelines and policies.
• Coach and educate coding staff to ensure adherence to ICD 10-CM/PCS, CPT/HCPCS coding guidelines and policies.
• Maintain working knowledge of CMS (Medicare and Medicaid) regulations, Local Coverage Determinations (LCD), National Coverage Determination (NCD), and National Correct Coding Initiatives (NCCI).
• Communicate quality audit results and recommendations to management in a clear and concise manner.
• Perform ad hoc quality reviews and audits as requested by management.
• Participate in team meetings with coding staff to discuss coding problems, changes, or issues.

• Associates Degree in Health Information Technology is Required.
• Bachelors Degree in Health Information Technology is Preferred.
• Inpatient Coding/Clinical documentation review is Preferred.
• 3 yrs of Coding/Clinical documentation Improvement is Preferred.
• RHIT/RHIA certification is Required.

We strive for excellence and insist on high standards of conduct and performance in everything we do. Our Model of Care and Conduct is designed to create a positive work environment which Methodist desires for all employees. As part of all position's duties at Methodist Hospitals, all employees are responsible to conduct themselves in accordance with the Model of Care and Conduct and will be evaluated according to these standards of behavior.