Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding accuracy against official guidelines; supports payment methodology.
Consulting: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding.
Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures; adheres to Standards of Ethical Coding (AHIMA) and reviews discharge disposition.
IP, OP Coding: Reviews medical records for accurate ICD-9-CM codes for diagnoses and procedures.
Coding: Uses discretion and specialized coding training to accurately assign ICD-9, CPT-4 codes to patient records.
Abstracting: Reviews medical records to determine accurate required abstracting elements including discharge disposition.
Coding Quality: Demonstrates accuracy and consistency in principal and secondary diagnoses and procedures, including MCC/CC, and abstracting elements per SOW.
CDI: Identifies and communicates documentation improvement opportunities and coding issues to appropriate personnel for follow-up and resolution.
Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other directives; attends seminars and quarterly updates.
Requirements
Associates degree in relevant field preferred or combination of equivalent of education and experience
Three years coding experience including hospital and consulting background