[Hiring] Medical Coding Auditor @Dutch Ridge Consulting Group

Role Description

DRCG is seeking a highly motivated Medical Coding Auditor to support a federal client. The Auditor will have expertise in:

• International Classification of Diseases (ICD)
• Current Procedural Terminology (CPT)
• Healthcare Common Procedure Coding System (HCPCS)

The Medical Coding Auditors will serve as experts of current coding conventions and guidelines related to professional and facility coding and perform audits of encounters to identify areas of non-compliance in coding.

This is a Part Time role, auditors must commit to a minimum of 5 hours up to 20 hours per week, scheduled at your discretion from Monday through Sunday weekly.

Location: Remote

Clearance Required: Tier Level 1

Responsibilities and Duties

• Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures, and health services principles to ensure proper code selection.
• Reviews assigned codes from the current version of several coding systems including ICD, CPT, and/or HCPCS.
• Applies guidelines specific to certain diagnoses, procedures, and criteria used to classify patients under the Veterans Equitable Resource Allocation (VERA) program.
• Monitors regulatory and policy requirements affecting coded information for services provided by the VAMC.
• Assists facility staff with documentation requirements to accurately reflect patient care provided.
• Reviews, analyzes, and reports performance monitors for PTF, PCE, VERA, and Non-VA Medical Care coding.
• Performs other duties as assigned.

Required Skills and Abilities

• Audit accurate and complete assignment of ICD-10-CM and ICD-10-PCS codes, MS-DRG, POA status, and discharge disposition values for inpatient health records.
• Facilitates improved overall quality, completeness, and accuracy of coded data.
• Ensures accuracy and completeness of clinical information for measuring and reporting outcomes.
• Responsible for performing audits of coded data, developing criteria, collecting data, graphing, and analyzing results.
• Collaboratively works with coding and clinical staff to provide support and education on coding issues.
• Provides training and education to coding and clinical staff.
• Research complex coding issues and participate in process improvements related to coding.
• Analyze audit results and prepare summary feedback for individual coders and/or clinicians.
• Provide coding consultation to coders and/or clinicians related to coding and documentation questions.
• Requires six additional months of creditable experience equivalent to a MRT (Coder).

Education and Experience

• Minimum of three (3) years' experience reviewing records.
• An associate's degree or higher in Health Care.
• One year of creditable experience indicating knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and health records structure.
• At least two (2) years of Veteran Affairs or relevant coding experience.
• Experience using VIRR/WebVIRR.
• Looking for coders who can commit to a minimum of 20 hours per week.

Certifications Required

• Apprentice/Associate level Certification through AHIMA or AAPC.
• Mastery Level Certification through AHIMA or AAPC.
• Clinical Documentation Improvement Certification through AHIMA or ACDIS.

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer.