Coding Auditor Needed to Support a Georgia Healthcare Company (Required Experience in ICD10 Cm/PCS Hospital Inpatient Coding and Auditing) 

Job ID: 24362
Pay Rate: $35.00/HR-$42.00/HR
Location: Remote
Employment Type: Contract to Hire
Schedule: Full Time

A leading healthcare organization in Georgia, recognized for its extensive network of hospitals, outpatient centers, and medical practices, as well as its commitment to comprehensive, innovative, and patient-centered care, is seeking a Coding Auditor. Reporting to the Assurance/Compliance team, the Coding Auditor ensures accuracy and compliance in coding, DRG assignment, discharge disposition, admit/discharge dates, and reimbursement processes. Responsibilities include auditing medical records, identifying and addressing coding errors, educating staff on compliance issues, coordinating payment corrections with the Billing and Revenue Cycle teams, and supporting the organization’s adherence to coding and regulatory standards. This role is instrumental in promoting ethical documentation, accurate coding, and compliant billing practices to mitigate risks related to fraud and abuse.
Qualifications include:

• Mandatory expertise in ICD-10-CM/PCS Hospital Inpatient coding and auditing.
• Required credentials upon hire: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder – Hospital Outpatient (CPC-H), or Certified Coding Specialist – Physician-based (CCS-P).
• Certified Risk Adjustment Coder certification required upon hire.

This position is ideal for a highly skilled professional dedicated to upholding compliance and excellence in healthcare coding and auditing standards.

What Your Day Looks Like:

Chart Review and Education:

• Audit hospital and/or physician medical records to ensure compliance with coding and regulatory standards.
• Validate coding accuracy, DRG assignments, discharge dispositions, and reimbursement processes.
• Educate coding staff, physicians, clinical personnel, and other hospital staff when errors are identified.
• Conduct training sessions on documentation, coding, and compliance requirements.

Payment and Reimbursement Coordination:

• Collaborate with the Billing and Revenue Cycle team to coordinate payment corrections.
• Investigate overpayment and underpayment issues through DRG reviews and audit requests.
• Direct resubmission of claims and assist in preparing disclosures when necessary.

Audit and Data Analysis:

• Conduct data sampling, auditing, and reporting based on the Annual Inpatient Coding Assurance Audit plan.
• Review Epic Work Queue assignments to ensure compliance with governmental and internal regulations.
• Research official guidelines to plan and execute focused reviews.
• Benchmark data analytics to identify trends, errors, and opportunities for revenue enhancement.
• Prepare Findings and Executive Summary reports for leadership and coding staff.

Compliance and Regulation Monitoring:

• Stay updated on CMS regulations and official coding guidelines.
• Summarize and disseminate National and Local Coverage Determinations.
• Monitor changes in coding and billing regulatory requirements and implement necessary updates.

Education and Communication:

• Develop and present coding and compliance educational materials to staff.
• Provide follow-up education after audits, including denial and appeal follow-up.
• Address compliance, documentation, coding, and billing queries from staff via email and other communication channels.

Process Improvement and Error Resolution:

• Identify and resolve trends and errors in coding or charge practices.
• Assist in implementing new processes to ensure error resolution and compliance.
• Work collaboratively across departments to address audit findings and implement solutions.

Other Duties as Assigned, Including:

• Document work processes as required.
• Participate in special audits and other assigned tasks.
• Comply with all organizational policies, standards of work, and the code of conduct.

What You Bring:

• Mandatory ICD10 Cm/PCS Hospital Inpatient Coding and Auditing
• (Required) Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder – Hospital Outpatient (CPC-H), or Certified Coding Specialist – Physician-based (CCS-P).
• (Required Upon Hire) Certified Risk Adjustment Coder.
• Associate's Degree in Business Administration/Management, Health Administration, or a related field. Bachelor’s or Master’s degree preferred.
• A combination of 5 years of comparable hospital coding, billing, and reimbursement experience may substitute for an Associate's degree.
• Minimum of 5 years of inpatient coding experience.
• 1-2 years of hospital-based outpatient services coding experience preferred.
• 1 year of inpatient coding audit experience preferred.
• Strong knowledge of medical terminology, ICD-10-CM/PCS, ICD-9-CM, CPT-4, and Level II HCPCS coding.
• Proficiency in Medicare and Medicaid reimbursement rules and regulations.
• Experience with hospital billing systems, medical chart reviews, and electronic medical records.
• Competence in Microsoft Word, Excel, and Access in a Windows environment.
• Excellent communication, organizational, and educational skills.
• Ability to work remotely and independently, with a self-driven focus on task completion.

Benefits Offered by Parker Staffing to Contract to Hire Employees:  

• Paid Sick/Safe Time (based on where allowable by law)  
• Medical benefits with multiple plan tiers and Telemedicine access  
• 401K with matching contributions   
• Holiday pay   
• Employee Assistance Program (EAP)

Parker Staffing offers all levels of Administrative, Customer Service, Call Center, Human Resources, and Non-Clinical Healthcare opportunities throughout the nation. Visit our employment opportunities page at http://www.parkerstaffing.com to review our full offering of temp, temp-to-hire, and direct hire job openings!  
 
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.