Lead Ambulatory Medical Coding Auditor

• Degree/Education: Certified through one of the following organizations: American Academy Professional Coders (AAPC) credentials-, CPC-H, CPC-P, CPMA or American Health Information Management Associations (AHIMA) credentials - RHIA, RHIT, and CCS-P).
• Experience: A minimum of three years medical coding experience in multiple clinical specialties and three years of auditing and supervisory experience within the last eight years, preferably with the Department of Defense (DOD). Expertise must also include ambulatory surgery coding/auditing for the outpatient auditor reviewing APV encounters.
• Other knowledge, skills, or abilities: Extensive knowledge for understanding and applying the official coding clinic guidelines and knowledge of medical terminology and usage, including general medical, surgical, pharmaceutical, hospital terms and abbreviations and abstracting techniques. Knowledge of a broad range of references such as the ICD-10, CPT, HCPCS, medical dictionaries, manuals relating to coding textbooks and glossaries. Knowledge of legal and regulatory requirements of medical records.

• Lead Audit coordinator may serve as an on-site manager, if site manager is not available.
• Lead Medical Coding Auditors for Outpatient shall be responsible for the performance of the work activities of all contracted auditing staff.
• Daily activities would include resolving any coding discrepancies, mediating disputes, setting audit assignments, time and attendance, and performance improvement planning.
• Provide educational feedback to the Government, Auditors and Provider’s addressing inappropriate patterns of documentation of records audited. Maintain records and statistics to include quality control measures, CCE reporting, MHS Genesis usage, accuracy of coding, workload completed and ad hoc reports as required.
• Shall develop and execute training that is specific to the clinical services provided by the MTF and will incorporate standardized training guidance to facilitate evolving requirements.
• Prepares approximately 52 productivity summaries per year.
• Ensures accurate coding of medical records utilizing JC, MHS and MTF guidelines.
• Completes all mandatory Command training and provide a training summary to the PAD leadership on a monthly basis.
• All audits of coded data for outpatient medical records (clinic visits), inpatient medical records, inpatient rounds, emergency room and ambulatory procedure visits, including data related to the provider information, dates of procedures and patient identifiable information, are completed in accordance with established official guidelines and without discrepancies.
• All audit spreadsheets are submitted to the WRNMMC site supervisor weekly without discrepancies.
• All data reports are prepared in the format specified by the Government.
• All log entries and reports required to support the program will be kept up to date.
• Conduct and provide regular statistics evaluations/reports.
• Ensure Coding Audits are done monthly (from previous month’s prior encounters and discharges) and submitted on the 10th of the following month, e.g. audit for April data submitted on June 10th.
• Schedule of trainings, topics. Clinic/provider(s) trained and copy of presentations, if anySubmit monthly report on activities done for the month, e.g. audit results, training provided and feedback.

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