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MEDICAL CODING AUDITOR (INPATIENT) - UNCHCS HIM CODING AND CDI

Company: UNC Health Care
Location: Chapel Hill
Posted on: January 9, 2019

Job Description:

MEDICAL CODING AUDITOR (INPATIENT) - UNCHCS HIM CODING AND CDI Job ID: HEA0095G Job Description This position may involve support of various hospitals and health care systems within the UNC Health Care System, but will be employed by Rex Hospital, Inc. (this includes, but is not limited to, for purposes of payroll, health benefits, retirement options, and applicable policies). If selected candidate is currently employed with UNC Health Care System the candidate will stay on current payroll and benefits platform. The Medical Coder Auditor reviews third party coding insurance denials, creates appeals, coordinates reviews by Clinical Documentation Integrity (CDI) Physician Advisors (PA). The medical coder auditor researches the medical record for denied cases to identify documentation to include in appeals and clinical references and coding clinics to support appeals. Appeals are submitted to insurance companies and uploaded in compliance auditing software and tracked and managed on a daily basis. The Medical Coder Auditor may request Peer to Peer discussions on behalf of the CDI PA's and the 3rd party Medical Director. The Medical Coder Auditor shares insurance denial findings that are accepted with the Coding and Quality HCS Manager for education. The medical coder auditor provides ongoing training/education and serves as a general resource to assist coders at all the HCS entities. The medical coder auditor communicates with physicians, physician advisors, HCS coding supervisors, and other health care staff to obtain missing information or to clarify existing information. The medical coder auditor accurately assigns International Classification of Diseases 10-CM (ICD-10) diagnosis codes and ICD-10-PCS procedure codes, have knowledge of Current Procedural Terminology (CPT) codes with modifiers, and other applicable codes. The medical coder auditor analyzes information for optimal and proper reimbursement as well as ensures compliance with all appropriate coding, billing and data collection regulations and procedures. The medical coder auditor provides information to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines. The medical coder auditor provides training to Physicians, non-physician providers, and their support staff. The Medical Coder Auditor must have sound knowledge of inpatient coding and coding guidelines. Qualifications Education Requirements: ? Associate?s degree in Health Information Management or related field or an equivalent combination of education and experience. ? Successful completion of the UNCH Coder Proficiency Test. Licensure/Certification Requirements: ? Must have one of the following: - AHIMA (American Health Information Management Association) certification - AAPC (American Academy of Professional Coders) certification - AAMA (American Association of Medical Assistants) certification Professional Experience Requirements: ? If Associate?s degree: Five (5) years of experience in medical coding or acute care. ? If High School Diploma: Nine (9) years of experience in medical coding or acute care. Primary Location: Chapel Hill, North Carolina, United States Department: U-28029-UNCHCS HIM CODING AND CDI Shift: Day Job

Keywords: UNC Health Care, Chapel Hill , MEDICAL CODING AUDITOR (INPATIENT) - UNCHCS HIM CODING AND CDI, Accounting, Auditing , Chapel Hill, North Carolina

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