Inpatient Coding Compliance Auditor

Position responsible for ensuring the accuracy and completeness of clinical coding resulting in the appropriate reimbursement and data integrity and validation of the coded information for external and internal affairs. This role involves conducting audits, developing educational sessions, and ensuring compliance with coding standards and guidelines.

Location: United States

Responsibilities

• Conducts regular coding audits and coordinates ongoing monitoring of coding accuracy, providing continuous feedback to coding staff.
• Develops and coordinates educational sessions to all coding staff regarding documentation and accurate coding.
• Serves as a resource for coding staff on organization-wide coding and documentation standards and guidelines.
• Designs audit tools to monitor the accuracy of clinical coding.
• Keeps abreast of coding guidelines and reimbursement reporting requirements.
• Conducts trend analyses to identify patterns and variations in coding practices.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
• Other duties as assigned.

Requirements

• High school diploma or GED, required.
• Inpatient coding certification(s) from AHIMA or AAPC required.
• Outpatient coding certification(s) from AHIMA or AAPC required.
• Four (4) years of relevant hospital coding or auditing experience required.
• Experience coding/auditing in a level 1 trauma facility/academic teaching facility strongly preferred.
• Extensive knowledge of ICD-10-CM and CPT coding principles and guidelines.
• Extensive knowledge of 3M Coding applications and resolving coding edits.
• Working knowledge of reimbursement systems and regulations and policies pertaining to documentation, coding, and billing.
• Knowledge of database applications and spreadsheet design.
• Effective oral and written communication skills.