• The Medical Coder Auditor will maintain an environment of safety for patients, self and others

• Perform daily review of coded inpatient medical records to validate principal diagnosis, secondary diagnoses and principal procedure sequencing and DRG assignment through the use of a specialized software program (PwC SMART)

• Provide feedback relating to corrections to inpatient coders

• The Medical Coder Auditor will perform review of coded inpatient records with Hospitalist Physician Advisors to analyze clinical data and validate the patient's severity of illness and intensity of service; to identify need to clarify physician documentation; to obtain adequate documentation to validate principal diagnosis and secondary code assignments; educate physicians on coding and documentation standards and regulations

• He/She will perform data collection and data entry of information obtained during Hospitalist medical record review and PwC SMART review worksheets

• The Medical Coder Auditor will collaborate with Access Management (Clinical Documentation Specialists) regarding discrepancies with coding and MSDRG assignments

• Act as a resource and provide education to CDS regarding rules and regulations regarding coding and MSDRGs

• He/She will perform reviews of coded outpatient visits to validate principal diagnosis, secondary diagnoses and procedure coding and sequencing

• Provide feedback relating to corrections to coders

• The Medical Coder Auditor will assist APC Regulatory Compliance Analyst by performing reviews of coded outpatient records to analyze clinical data and validate diagnosis and procedure coding and sequencing; to identify need to clarify physician documentation; to obtain adequate documentation to validate principal diagnosis and secondary code assignments; educate hospitals departments and physicians on coding and documentation standards and regulations

• The Medical Coder Auditor will assist manager with training new coders or contract coders to include daily monitoring, feedback and education; researches and educate outpatient coders on ICD-9-CM and CPT-4 coding changes as well as complex coding issues

• Remain current with AHA Coding Clinic, CPT Assistant, CMS guidelines and other required reporting and assist with coder education of these topics in monthly coding meetings as needed

• He/She will assist manager by reviewing complex records to include coding related correspondence from CMS as well as other regulatory agencies, insurance providers and internal audits, etc.

• Conduct other coding and abstracting reviews as assigned by manager

• Prioritize record review according to established procedure to expedite the review process

• The Medical Coder Auditor will assist with coding as needed in times of short-staffing, high volumes, vacancy, etc. as needed.             

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