Inpatient QA Auditor | CCS or CIC  

• Performs audits of Inpatient medical records documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes. Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates. Draws on advanced ICD-10 coding and/or CPT and HCPCS coding expertise, as well as industry knowledge to substantiate conclusions.
• Assists in the development and testing of new audit concepts or tools
• Contributes new ideas for improving existing audit processes to optimize efficiency and quality.
• Consistently achieves productivity and quality performance standards established by management
• Assists with training new Coders to include daily monitoring, mentoring, feedback and education.
• Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification
• Responsible for attending training and scheduled meetings to enhance skills and working knowledge of coding policies, procedures, and guidelines.
• Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce to meet client needs
• Performs other functions as assigned

Qualifications:

• Professional Coding Experience in Inpatient encounters
• Demonstrated proficiency in medical record coding and auditing and ICD-10 CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology.
• Demonstrated ability to write clear, accurate, concise rationales in support of findings.
• Ability to multi-task in a fast paced working environment.
• Ability to work independently in a production environment
• Ability to build relationships both internally and externally.
• Demonstrated proficiency in computer skills and typing, i.e., Microsoft Windows, Outlook, Word, Excel, PowerPoint, Internet browsers, etc.
• Demonstrated knowledge of medical codes, coding conventions and rules.
• Demonstrated experience with coding systems.
• Working knowledge of HIPAA Privacy and Security Rules.
• Certifications (One of the following Required):
o CCS or CIC only