Coding Quality Assurance Auditor

Overview:

Performs coding audit activities for the NHmg RCS Coding Department. He/she will be responsible for conducting audits that include assessments of proper use of ICD-9-CM, ICD-10-CM, CPT and HCPCS codes, modifiers, NCCI usage and all other applicable coding guidelines. The Coding Quality Assurance Auditor will support the coding department by pro-actively auditing the team according to the RCS audit policy, and documenting/reporting issues identified during auditing processes.

At Novant Health, one of our core values is diversity and inclusion. By engaging the strengths and talents of each team member, we ensure a strong organization capable of providing remarkable healthcare to our patients, families and communities. Therefore, we invite applicants from all group dynamics to apply to our exciting career opportunities.

Qualifications:

• Education: High School Diploma or GED, required.
• Experience: Five years of professional coding experience (in all core areas), required. Minimum of two years auditing experience for coding compliance/accuracy, required.
• Licensure/certification: CPC, CCS or RHIT; required. CPMA, preferred.
• Additional skills required: Extensive knowledge of ICD-9-CM, ICD-10-CM, CPT and HCPCS coding principles and guidelines. Extensive knowledge of reimbursement systems. Audit experience preferred. Extensive knowledge of federal, state, and payer specific regulations and policies pertaining to documentation, coding and billing. Excellent verbal and written communication skills. Ability to effectively communicate with coding team members, providing positive constructive feedback from audit results. Medical terminology, advanced level; Anatomy & Physiology with laboratory experience preferred; Proven analytical ability and organizational skills necessary to organize/assess quality assurance based on data analysis.
• Additional skills preferred: In depth background and knowledge of medical documentation, fraud, abuse, and penalties for documentation and coding violations based on government guidelines. Scope and statistical sampling methodologies. Medical record auditing skills and abstraction ability. Quality assurance and coding risk analysis.

Responsibilities:

It is the responsibility of every Novant Health team member to deliver the most remarkable patient experience in every dimension, every time.

• Our team members are part of an environment that fosters team work, team member engagement and community involvement.

• The successful team member has a commitment to leveraging diversity and inclusion in support of quality care.

• All Novant Health team members are responsible for fostering a safe patient environment driven by the principles of "First Do No Harm".