Coding Auditor - Full Time 80 at Saint Agnes Medical Center

Posted in Other 11 days ago.

Location: Fresno, California

Job Description:

Employment Type:

Full time


Day Shift


Reporting to the Manager Medical Group Revenue Cycle Site Operations, Fresno, this position is responsible for to perform medical record audits including, but not limited to analysis of medical record documentation; validation of primary and secondary diagnoses and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Monitor's accuracy of centralized coder's charge capture and coding with proper International Classification of Diseases 10th Revision (ICD-10), Current Procedural Terminology (CPT), Healthcare Common procedure Coding System (HCPCS), as well as proper modifiers, adhering to local ministry and Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder education. Conducts ongoing reviews of patient medical record documentation and procedural and diagnosis coding by each practitioner. Responsible for practitioner education in areas related to coding, documentation and compliance.
1. High school diploma or equivalent is required.
2. Two (2) years of professional coding experience with comprehensive knowledge of ICD-10, CPT, and HCPCS modifiers and
knowledge of Medicare, Medicaid, and other third-party billing rules and regulations is required. Three (3) years of professional coding
experience; ability to code from operative reports, progress, and other note types with prior auditing experience is preferred.
3. Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), CRC or Certified Documentation Expert
Outpatient (CDEO) accreditation is required.
4. Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations is
5. Ability to work collaboratively in a team-oriented environment with a strong customer-service orientation is required.
6. Ability to handle patient and organizational information in a confidential manner is required.
7. Demonstrated dependability and regular attendance is required.
8. Ability to demonstrate competency with a standard desktop and Windows-based computer system, including a basic understanding
of email, e-learning, intranet and computer navigation and the ability to use other software as required to perform the essential
functions of the job are required.
9. Must have a solid understanding of ICD-10 and CPT coding and medical terminology, with knowledge of Medicare, Medicaid,
Health Maintenance Organization and commercial insurance plans.
10. Must have the ability to maintain accurate records and to prioritize and organize work effectively and the ability to exercise
independent judgment as appropriate within standard practices and procedures.
11. Familiarity with standard desktop and windows-based computer system, including email, e-learning, intranet and computer
12. Ability to use other software required to perform essential functions is required. Athena and/or Epic experience preferred.
13. Must have the ability to work in a fast-paced professional central billing environment requiring flexibility to adapt to changes in
workload, competing priorities, and deadline situations.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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