Coding Compliance Auditor – Health Information Management – Full Time Hour Days (Non-Exempt) (Non-Union)

In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments – and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers.   All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also, provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re: coding accuracy rates, compliance rates, denial analytics, etc.  Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers.  Understands coding/billing computer systems such as Cerner, MediTech, Epic, and Athena IDX in a manner to assure clean claims release for billing in a timely manner.  Participate in response to inquiries regarding coding and documentation from coders, providers, and all other hospital staff.  Perform other coding department related duties as assigned by Coding management.

Minimum Education:
• High school diploma
• Successful completion of college courses in Medical Terminology, Anatomy & Physiology and a certified coding course. (Combined education/experience can substitute for Completion of Specialized/Technical Training Courses)

Minimum Experience/Knowledge:
• Five (5) years of experience in ICD-9 & ICD-10 (combined) coding and auditing of Professional charges, E/M, surgical, and multispecialty medical records in the clinic and hospital setting and experience in researching CMS regulations and guidance for documentation and coding.

Required License/Certification:
Minimum National Certification:
• AAPC Certified Professional Coder (CPC), or AHIMA Certified Coding Specialist – Physician (CCS-P)
• Successful completion of the professional specific coding test – with a passing score of ≥85%. The coding test may be waived for former USC or agency/contract Coding Dept. coders who historically/previously met the ≥ 90% internal/external audit standards of the previously held USC Job Code.
• Fire and Safety Certification. If no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date. (Required within LA City only)