Coding Auditor (ICD-10)

divh2Coding Auditor (ICD-10)/h2pPosition: Coding Auditor (ICD-10)/ppDuration: Full-Time/ppLocation: Newark/Wall NJ/ppJob Summary:/ppThis position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9-CM, ICD-10, DRG assignment payment and auditing./ppResponsibilities:/pp Identifies and presents billing discrepancies found during audit and coordinates referral of improper claim payments through the appropriate channels./pp Identifies error trends as they relate to medical record and or billing documentation or misinterpretation of provider contract stipulations./pp Compiles statistics and other audit information to present to accounts, regulatory agencies, and internal requesters./pp Reviews and updates audit processes with manager for purposes of keeping up with new innovations in clinical data review and company cost containment initiatives./pp Required to train new staff on department/audit procedures./pp Performs other special assignments as requested by manager./pp Demonstrates knowledge, understanding and conforms to laws, regulations and policies that pertain to the organizational units business./ppKnowledge:/pp Requires knowledge of medical terminology, detailed knowledge of anatomy physiology, disease pathogenesis and treatment including procedural drug therapies, ancillary and diagnostic services./pp Requires knowledge of principles of utilization management./pp Requires knowledge of hospital structures and payment systems./pp Requires knowledge of Centers of Medicare and Medicaid prospective payment system regulations./pp Prefers knowledge of ACCESS Software./pp Must have effective verbal and written communication skills and demonstrate the ability to work well within a team. Demonstrated ability to deliver highly technical information to less technical individuals./pp Must have strong PC skills experience with MICROSOFT office programs: excel, word and power point./pp Must demonstrate professional and ethical business practices, adherence to company standards, and a commitment to personal and professional development./pp Proven time management skills are necessary. Must demonstrate the ability to manage multiple priorities [or tasks], deliver timely and accurate work products with a customer service focus, and respond with a sense of urgency as required. Demonstrated ability to work in a production focused environment./pp Proven ability to ask probing questions and obtain thorough and relevant information./pp Needs to demonstrate willingness to cross-train, and be cross-trained, in other roles/duties./pp Must be detail oriented with strong organizational and data processing skills. Proven ability to follow detailed instructions is essential, along with proven problem solving skills./pp Proven analytical, research and problem solving skills a must./ppTravel (If Applicable):/pp Field position: 85 to 90% of time spent in the field at various facilities in NJ, PA NY/ppQualifications:/ppEducation:/pp Requires a Bachelors degree in Health Information Management or related field; or a RN with CCS certification./ppExperience:/pp Requires a minimum of 3 years of experience in a medical records department of an acute care hospital or other health care facility. Experience with DRG validation, ICD-9-CM or ICD-10 training and education./ppAdditional licensing, certifications, registrations:/pp Requires RHIA or RHIT certification; or RN with CCS certification./pp Valid Drivers license and access to a car./p/div