The CSI Companies
Revenue Integrity Coding Auditor
The CSI Companies, Little Rock, AR
Revenue Integrity Coding AuditorLocation: Remote/Hybrid - Open to All States
Travel Requirement: Must be willing to travel to Arkansas for orientation (travel expenses likely self-funded). Suggested to stay close to the orientation location.
Salary: $75,000 - $90,000 Base
Position SummaryWe are seeking a highly skilled and experienced Revenue Integrity Coding Auditor to join our dynamic team. The ideal candidate will possess a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification and have a minimum of 3 years of Inpatient and/or Outpatient coding experience. This role is crucial in ensuring accurate coding, MS-DRG assignment, and compliance within our healthcare organization.
Work Schedule
Collaboration:
Auditing and Reporting:
Training and Education:
External Audits:
Note: This job description is subject to change as the needs of the organization evolve.
Qualifications/Specifications
Travel Requirement: Must be willing to travel to Arkansas for orientation (travel expenses likely self-funded). Suggested to stay close to the orientation location.
Salary: $75,000 - $90,000 Base
Position SummaryWe are seeking a highly skilled and experienced Revenue Integrity Coding Auditor to join our dynamic team. The ideal candidate will possess a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification and have a minimum of 3 years of Inpatient and/or Outpatient coding experience. This role is crucial in ensuring accurate coding, MS-DRG assignment, and compliance within our healthcare organization.
Work Schedule
- Full-time: 40 hours per week
- Monday - Friday
- Conduct reviews of Clinical Documentation Improvement (CDI) mismatches.
- Evaluate responses to late query submissions.
- Assess Besler quality recommendations.
- Examine coding issues related to medical necessity and other concerns.
- Investigate MS-DRG denials.
- Conduct coding compliance research.
- Perform RVU analysis.
- Review high-risk cases (e.g., Impella, TCAR, Aveir DR).
- Handle rebill requests.
- Address discharge not final billed (DNFB) reports.
- Provide continued support for charge review.
Collaboration:
- Work closely with providers, clinical, coding, and CDI team members.
- Respond to coding questions and collaborate with the CDI QA team on DRG reconciliation.
- Collaborate with the Director of HIM/Coding/Billing on coding quality and education recommendations.
Auditing and Reporting:
- Perform random and focused medical records reviews for accurate coding and MS-DRG assignment.
- Summarize audit findings and provide feedback to the Director.
- Maintain detailed records of audits, results, recommendations, and follow-up actions.
Training and Education:
- Assist in the training of new coding team members.
- Contribute to educational activities for all coding team members.
- Educate providers on coding updates, documentation standards, and summary reviews.
External Audits:
- Review and respond to third-party coding audits/reviews.
- Increasing efficiency in coding processes.
- Reducing Days Not Final Billed (DNFB).
- Decreasing Accounts Receivable (AR) days.
- Providing research support for coding and RVU-related questions.
- Improving cash flow.
Note: This job description is subject to change as the needs of the organization evolve.
Qualifications/Specifications
- Education: High School diploma or equivalent required.
- Licensure/Certification: Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.
- Experience: Minimum of three years of experience in medical coding with ICD-10 and CPT coding systems required. Detail-oriented and experienced coding professional with a passion for ensuring accuracy and compliance.