[Hiring] External Auditor @Omega Healthcare Solutions

Role Description

Under general supervision of client, Omega’s External Auditor Inpatient will perform reviews of inpatient and outpatient or Professional Services medical records for coding accuracy and medical record documentation as it impacts the accuracy of ICD-10-CM, ICD-10-PCS codes driving MS-DRG assignment and ICD-10-CM and CPT-4/HCPCS codes driving the APC assignment. The External Auditor Inpatient must be able to identify Physician query opportunities, write compliant queries, assess the accuracy of POA, discharge disposition and modifier assignments. External Auditor Inpatient performs data collection for quality and statistical purposes and reports the findings to Omega’s clients.

Qualifications

• Associate’s Degree or equivalent training acquired through on-the-job experience.
• At least two years of HIM experience, preferably as an Auditor.
• At least one year of auditing experience.
• Minimum of successful completion of an AHIMA approved Coding Certificate Program.
• CCS, CPC, CPC-P, CPC-H, RHIA or RHIT.

Requirements

• Review inpatient, outpatient, or physician services medical records for accuracy of coding and data quality, including:
• Inpatient/Observation Cases:
• All diagnosis and procedure assigned ICD-10-CM and ICD-10 PCS codes
• Discharge disposition assigned
• Assigned Present on Admission (POA) indicators
• APR, SOI, and ROM assignment for inpatient cases
• Outpatient Cases (ER, SDS, Ancillary):
• All diagnosis and procedure assigned ICD-10-CM and ICD-10 PCS codes
• All CPT assigned codes
• Modifier use and assignment
• APC assignment
• Professional Services:
• All diagnosis codes assigned ICD-10 CM
• All CPT codes
• All E&M Leveling codes
• Maintain auditing productivity based on Client and Omega agreed upon requirements.
• Complete Quality Review reports timely and submits to Client for review.
• Utilize all available official references to perform reviews, including but not limited to:
• International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM)
• Current Procedural Terminology (CPT-4) Official Coding Guidelines
• Coding Clinic
• CPT Assistant
• CMS guidelines
• Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.

Benefits

• Comprehensive benefits package may include health, dental, and vision coverage.
• Voluntary insurance options.
• 401(k) plan with employer match.
• Professional development opportunities.
• Paid time off and holiday pay.
• Opportunity to participate in bonus programs, commissions, or other variable incentive plans.

Company Description

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines.