HIM Coding Auditor Lead - Cancer Center
University of Kansas Health System
- Lenexa, KS
- Permanent
- Full-time
- Reviews samples of coded services daily for accuracy and completeness including physician surgical, both inpatient and outpatient, facility charges, procedural, and physician inpatient and outpatient documentation and coding.
- Participates in the development of coding policies and procedures.
- Remains up to date on all regulatory and private payor policies, compliance policies, and coding updates or changes.
- Oversees coding reviews with both coders and physicians or other providers and provides detailed feedback and education on coding practices and conventions to foster improvement.
- Gathers and considers patient reimbursement data, analyzes results and reviews reimbursement for low payments.
- Serves as a resource for the coding and billing staff providing education and answering questions.
- Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and coding guidelines to inpatient and outpatient diagnoses and procedures.
- Communicates pertinent information on appropriate documentation to physicians and staff.
- Reviews the complex (problematic coding that needs research and reference checking medical records and accurately codes the primary/secondary diagnoses and procedures using ICD-10-CM and CPT coding conventions.
- Assists physician coding supervisors with Epic work queue monitoring and reconciliation of missed charging for inpatient, outpatient, and surgical encounters, performs monthly audits of coding quality and coder training as needed.
- Must be able to meet productivity requirements as outlined by clinical specialty and hospital quality requirements of 95% or better after training has concluded.
- High school diploma or GED
- At least one of the following certifications is required: CPC, COC, CIC or CCA, COC-A along with a CPMA, CRC, CPC-I, RHIT, or RHIA.
- 4+ years of experience in coding in health care facility or physician office specifically in specialty and surgical coding.
- English
- Associates Degree in related field
- CPMA - Certified Professional Medical Auditor certification preferred
- physician’s office with 1-2 years auditing experience preferred