[Hiring] Senior Inpatient Coding Auditor @Prisma Health

Role Description

Responsible for leading coding teams, coder training, work queue management, performing prebill and second-level coding reviews utilizing auditing software and documenting findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment.

Qualifications

• Associate degree or Coding Certificate through approved American Health Information Management (AHIMA) or other coding certification program.
• Four (4) years of experience in inpatient coding and abstracting with healthcare billing process in acute care setting.

Requirements

• Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential.
• Knowledge of electronic medical records and 3M or Encoder System.
• Knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process.
• Knowledge of MS DRG prospective payment system and severity systems.
• Knowledge of clinical documentation improvement principles, quality indicators, formal and informal coding audit process.
• Ability to work effectively, independently and manage multiple demands consistently.
• Proficient computer skills (spreadsheets and database).
• Strong knowledge of medical terminology and basic anatomy and physiology, pathophysiology, and pharmacology with the ability to apply this knowledge to the coding process.
• Ability to apply broad guidelines to specific coding situations, independently utilizing discretion and a significant level of analytic ability preferred.

Benefits

• Inspire health.
• Serve with compassion.
• Be the difference.

Company Description

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.