Coding Auditor
5 days ago
**Qualifications**
- Demonstrates working knowledge of the English language, verbal and written
- Prior history as Clinical Documentation Specialist role, leadership skills, helpful
- Requires course work in/knowledge of medical terminology, anatomy and physiology, pathophysiology in order to interpret data on patient documentation
- Working knowledge of all areas of adult medicine
- Demonstrates strong interpersonal and communication skills necessary to interact effectively with all internal and external customers, verbally and in writing, as required
- Requires strong organizational and analytical skills in order to prepare and maintain various documentation/reports
- Demonstrates the knowledge and understanding of intensity of service, severity of illness, opportunities for intervention, planned course of treatment/procedures, care needs, and outcome goals
- Requires excellent observation skills, analytical thinking, and problem solving ability
- Requires strong critical thinking skills, ability to assess/evaluate/teach
- Associates Degree in Health Information Technology is Required
- Certifications and Licensures
- RHIT/RHIA certification is Required
**Responsibilities**
- Responsible for ensuring accuracy and quality coding assignments for all records requiring DRG and/or APC coding; ensures optimal and timely reimbursement
- Performs comprehensive pre-billing coding audits, through the use of evaluator, to ensure claims are accurately coded and charged in compliance with coding and regulatory standards
- Performs comprehensive pre-billing coding 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
- Responsible for completion of reviews within 72 hrs of import date to include new reviews of up to or exceeding 12 to 15 per day for inpatients and/or completion of reviews within 48 hrs of import date including up to or exceeding 50 per day for outpatient accounts
- Maintains an audit response turnaround time of 24 to 48 hours, with the exception of weekends
- Reviews abstracted data to ensure quality of required data elements (facility specific elements) including appropriate discharge disposition
- Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient and/or inpatient records
- Coaches and educates coding staff to ensure staff adheres to ICD 10-CM/PCS, CPT/HCPCS coding guidelines and policies
- Maintains working knowledge of CMS (Medicare and Medicaid) regulations, Local Coverage Determinations (LCD), National Coverage determination (NCD) and National Correct Coding Initiatives (NCCI)
- Communicates quality audit results and recommendations to management in a clear and concise manner
- Performs ad hoc quality reviews and audits as requested by management
- Participates in team meetings with coding staff to discuss coding problems, changes, or issues
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and monitors coding staff for violations and reports to leadership when areas of concern are identified
- Performs other duties as needed and/or assigned
- Demonstrates basic understanding of coding guidelines.
Work Location: In person
-
Auditor - Mhs
2 weeks ago
Bengaluru, India TÜV SÜD Full time**Tasks** - **I.** **Responsibility and Authority** - 1. Perform audit according to standard requirements, regulatory requirements, internal requirements, code of conduct. - 2. Collect and analyze sufficient information to provide a recommendation for certification, with authority over the control and performance of auditing activities. - 3. Review medical...
-
Income Auditor
1 week ago
Bengaluru, Karnataka, India The Chancery Pavilion Full time**Years of Experience**:Atleast 2 to 3 years** **The Income Auditor is responsible for**: To audit and verify all revenue transactions, record them and prepare daily and monthly sales and other reports for management according to hotel policies and procedures. **The normal scope and work performed includes but is not limited to**: Audit all revenue...
-
Managers
2 weeks ago
Bengaluru, India Cigma Medical Coding Academy Full timeJob Description Job Description: - Team management:Interview, train, motivate, and reward the coding department staff. - Workflow management:Field questions from coders, auditors, and clients; establish procedures; coordinate schedules; and expedite workflow. - Reporting:Compile status and work-volume reports for management. - Client communication:Serve as a...
-
Auditor
2 weeks ago
Bengaluru, India Target Full timeAbout us:As a Fortune 50 company with more than 400,000 team members worldwide, Target is an iconic brand and one of America's leading retailers.Joining Target means promoting a culture of mutual care and respect and striving to make the most meaningful and positive impact. Becoming a Target team member means joining a community that values different voices...
-
Auditor
3 days ago
Bengaluru, India Target Full timeAbout us:As a Fortune 50 company with more than 400,000 team members worldwide, Target is an iconic brand and one of America's leading retailers.Joining Target means promoting a culture of mutual care and respect and striving to make the most meaningful and positive impact. Becoming a Target team member means joining a community that values different voices...
-
Auditor
5 days ago
Bengaluru, India Target Full timeAbout us:As a Fortune 50 company with more than 400,000 team members worldwide, Target is an iconic brand and one of America's leading retailers.Joining Target means promoting a culture of mutual care and respect and striving to make the most meaningful and positive impact. Becoming a Target team member means joining a community that values different voices...
-
Director Medical Coding
3 days ago
Bengaluru, India Taglynk Full timeResponsibilities:- Lead and scale the Medical Coding function, ensuring top-tier accuracy, compliance, and audit quality.- Drive automation initiatives in partnership with product and engineering to enhance coding efficiency and reliability.- Provide domain expertise to improve algorithms, training datasets, and clinical decision logic.- Build, mentor, and...
-
Director Medical Coding
2 days ago
Bengaluru, India Taglynk Full timeResponsibilities:- Lead and scale the Medical Coding function, ensuring top-tier accuracy, compliance, and audit quality.- Drive automation initiatives in partnership with product and engineering to enhance coding efficiency and reliability.- Provide domain expertise to improve algorithms, training datasets, and clinical decision logic.- Build, mentor, and...
-
Auditor
2 weeks ago
Bengaluru, India Target Full timeAbout us: As a Fortune 50 company with more than 400,000 team members worldwide, Target is an iconic brand and one of America's leading retailers. Joining Target means promoting a culture of mutual care and respect and striving to make the most meaningful and positive impact. Becoming a Target team member means joining a community that values different...
-
Auditor
2 weeks ago
Bengaluru, India Target Full timeAbout us: As a Fortune 50 company with more than 400,000 team members worldwide, Target is an iconic brand and one of America's leading retailers. Joining Target means promoting a culture of mutual care and respect and striving to make the most meaningful and positive impact. Becoming a Target team member means joining a community that values different...
