The responsibilities of the Coding Auditor are to perform reviews by validating accuracy of the coding billed in relation to the medical documentation. The coding auditor determines if a discrepancy exists in the coding and documents the findings using standard documentation guidelines applicable to the program. The audits may be performed as desk or as a facility onsite. The coding auditor may need to travel to the providers location on an agreed upon schedule and perform the audit review.
Key Duties and Responsibilities:
Reviews medical records and coding to validate Outpatient billing to include Professional, Hospital, APC assignment.
Responsible for updating SCIOmine (internal tool) with audit findings and completing audits assigned on a daily basis
Ability to write professional notes based on Scio Health Analytics policies using Official Coding guidelines, ICD-10 Coding Handbook, Coding Clinic and/or other recognized sources.
Review appeal information and render coding decision to either uphold or overturn original finding
Comply with all National Audit Employee Handbook policies and procedures - Comply with HIPAA and other regulations regarding confidentiality of information