Medical Coder

Irvine, CA

Post Date: 01/11/2018 Job ID: 2851537 Industry: Medical Coder
The Coding Auditor is responsible for performing coding validation reviews of medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This involves completing medical review forms, accurately documenting findings and providing policy/regulatory support for determination. Main Duties & Responsibilities:- Reviews medical information to collect data, ensure appropriate billing of data and follow up on concerns raised by nurse and physician reviewers or health care providers. Applies knowledge of Medicare/Medicaid rules and regulations pertaining to appropriate billing and coding of Medicare or Medicaid accounts.- Offers quality improvement suggestions on project protocols and processes; facilitates quality improvement plan development and implementation as requested, both internally and with external customers.- Identifies and coordinates routine contract deliverables to include producing and performing quality assurance on existing client reports and contact logs and all other reports requested by internal and external customers.- Communicates with health care professionals as a liaison regarding contract specifications. Relates any questions or concerns that cannot be addressed to Sr. Coding Specialist or management for follow up. Distributes contract-specific information as appropriate; adheres to work completion due dates. - Assists with project data analysis, reporting, and feedback.- Shares ideas on clinical topics through identification of needs or concerns within the community as a result of interactions.Required Skills:- Demonstrated proficiency in medical record analysis and ICD-9-CM and CPT coding methodology.- Demonstrated knowledge of medical codes, coding conventions and rules.- Demonstrated experience in medical review, chart audits, and quality improvement processes.- Demonstrated experience with coding systems.- Working knowledge of HIPAA Privacy and Security Rules.- Ability to communicate both verbally and in writing, fluently in English.- Ability to be careful and thorough about detail.- Ability to analyze information and use logic to address work-related issues and problems.- Ability to multi-task.- Ability to build relationships both internally and externally.- Ability to sit and work at a computer for an extended period of time.- Ability to demonstrate customer service and public relations skills.- Ability to demonstrate team process and facilitation skills.Required Education/Experience:- High School diploma required; Associates degree preferred- RHIA, RHIT, RN, CCS, CPC, or other licensed/accredited health care professional specific to scope of contract 3+ year's clinical medical record coding experience in preferably a hospital setting; or equivalent combination of education and experience.

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