[Hiring] Coding Auditor @OSF HealthCare

Role Description

The Coding Auditor is responsible for performing coding and documentation reviews to ensure the quality and integrity of coding data captured for OSF services. Responsibilities include:

• Providing validation of accurate and compliant coding and charging to ensure adherence to established coding guidelines of ICD-10, CPT, governmental and third-party payers.
• Ensuring coding quality standards are achieved and maintained.
• Responding to external coding audits and DRG billing denials, writing appeals, documenting coding rationale, and defending OSF coded data based on provider documentation and coding rule and convention as appropriate.
• Researching coding and/or billing code requirements using encoders and various professional and government publications to achieve compliance and optimize reimbursement.
• Participating in productive coding workflows to maintain up-to-date knowledge of current documentation and coding software toolset.

Qualifications

• Education: Associates degree in Health Information Management OR Bachelor’s degree in applicable health-related field.
• Licensure/Certifications: Must have one of the following certifications:
  • RHIA (Registered Health Information Administrator)
  • RHIT (Registered Health Information Technician)
  • CCS (Certified Coding Specialist)
  • CMA (Certified Medical Office Assistant)
  • CPC (Certified Professional Coder)
  OR will obtain AHIMA- CCS certification within 12 months of hire.
• Experience: 3 years of experience in hospital or professional coding.
• Other skills/knowledge:
  • Advanced knowledge of ICD10-CM/PCS and CPT/HCPCS coding guidelines.
  • Knowledge of medical terminology, anatomy/physiology, disease processes, medical records, and hospital procedures.
  • Ability to concentrate on a task over a period of time without being distracted.
  • Basic keyboard and software application skills, including Electronic Medical Record systems.
  • Demonstrated ability to communicate effectively via written and verbal means.
  • Demonstrated excellent professional writing skills.
  • Analytical skills necessary in collecting, analyzing, and reporting departmental quality indicators ensuring compliance with regulatory data requirements, establishing coding area goals, and assessing outside coding review activities.

Requirements

• Fluency with advanced understanding of both MS and APR DRG methodologies.
• Direct experience with chart quality audits and/or denial response writing.

Benefits

• Comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition, and well-being offerings.
• Expected pay for this position is $29.01 - $34.13/hour. Actual pay will be determined by experience, skills, and internal equity.