University of Southern California
Coding Compliance Auditor (HIM Inpatient) - HIM Financial - Full Time 8 Hour Day
University of Southern California, Alhambra, California, us, 91802
Coding Compliance Auditor (HIM Inpatient)
Location:
Keck Medicine of USC, Alhambra, CaliforniaType:
Full Time, 8 Hour Days (Non-Exempt, Non-Union)In accordance with current federal & state coding compliance regulations and guidelines, the 'IP Coding Compliance Auditor' performs 2nd level reviews of previously coded inpatient accounts for MS-DRG validation purposes, including the accuracy and completeness of all ICD-10-CM and ICD-10-PCS code assigned by inpatient coders. Ensure appropriate MS-DRG & APR-DRG, including SOI & ROM scores. Performs targeted/focused 2nd level reviews on Cloudmed & CCI external audit findings. Work with other stakeholders to perform targeted/focused 2nd level reviews per internal project requests by Revenue Cycle Departments (i.e., PFS, Patient Access, Case management), CDI, Quality, Risks, physician providers/Medical Staff committees, C-Suite, etc. All assigned codes and DRG classifications must be supported by clinical documentation contained in the medical record and must be in compliance with federal coding laws, rules, regulations, Official Coding Guidelines, and the AHA Coding Clinic.Essential Duties:Perform monthly internal coding audits to evaluate accuracy of coding staff to ensure a 95% coding accuracy rate.Develop monitoring/education plans for coding staff who do not meet the 95% accuracy rate.Recognize education needs of staff based on monthly reviews and conduct related in-services, as needed.Act as a resource to coding and hospital staff on coding issues and questions.Inpatient coding of all diagnostic and procedural information from the medical records using ICD-10-CM, ICD-10-PCS, and CPT/HCPCS, and abstracting patient information as established and required by official coding laws, regulations, rules, guidelines, and conventions.Enter patient information into inpatient and outpatient medical record databases (ClinTrac/HDM). Ensure accuracy and integrity of medical record abstracted UB-04 & OSHPD data elements prior to billing interface and claims submission.Maintain expected productivity standards and strive to maintain a steady level of productivity.Participate in continuously assessing and improving departmental performance.Required Qualifications:High school or equivalent.Specialized/technical training: Successful completion of college courses in Medical Terminology, Anatomy & Physiology, and a certified coding course.10 years of experience in ICD coding and DRG validation audits of inpatient medical records in an acute care facility.Experience in using a computerized coding & abstracting database software and encoding/code-finder systems (e.g., 3M 360 Encompass/CAC & 3M Coding & Reimbursement System (CRS)).Working knowledge of CPT, HCPCs, and ICD9 coding principles.Demonstrate excellent customer service behavior and communication skills.Preferred Qualifications:AHIMA Certified Coding Specialist (CCS) or AAPC Certified Inpatient Coder (CIC).Fire Life Safety Training (LA City) if applicable.The hourly rate range for this position is $39.00 - $63.95. When extending an offer of employment, the University of Southern California considers factors such as the scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.Posted Date:
11/16/2023
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Location:
Keck Medicine of USC, Alhambra, CaliforniaType:
Full Time, 8 Hour Days (Non-Exempt, Non-Union)In accordance with current federal & state coding compliance regulations and guidelines, the 'IP Coding Compliance Auditor' performs 2nd level reviews of previously coded inpatient accounts for MS-DRG validation purposes, including the accuracy and completeness of all ICD-10-CM and ICD-10-PCS code assigned by inpatient coders. Ensure appropriate MS-DRG & APR-DRG, including SOI & ROM scores. Performs targeted/focused 2nd level reviews on Cloudmed & CCI external audit findings. Work with other stakeholders to perform targeted/focused 2nd level reviews per internal project requests by Revenue Cycle Departments (i.e., PFS, Patient Access, Case management), CDI, Quality, Risks, physician providers/Medical Staff committees, C-Suite, etc. All assigned codes and DRG classifications must be supported by clinical documentation contained in the medical record and must be in compliance with federal coding laws, rules, regulations, Official Coding Guidelines, and the AHA Coding Clinic.Essential Duties:Perform monthly internal coding audits to evaluate accuracy of coding staff to ensure a 95% coding accuracy rate.Develop monitoring/education plans for coding staff who do not meet the 95% accuracy rate.Recognize education needs of staff based on monthly reviews and conduct related in-services, as needed.Act as a resource to coding and hospital staff on coding issues and questions.Inpatient coding of all diagnostic and procedural information from the medical records using ICD-10-CM, ICD-10-PCS, and CPT/HCPCS, and abstracting patient information as established and required by official coding laws, regulations, rules, guidelines, and conventions.Enter patient information into inpatient and outpatient medical record databases (ClinTrac/HDM). Ensure accuracy and integrity of medical record abstracted UB-04 & OSHPD data elements prior to billing interface and claims submission.Maintain expected productivity standards and strive to maintain a steady level of productivity.Participate in continuously assessing and improving departmental performance.Required Qualifications:High school or equivalent.Specialized/technical training: Successful completion of college courses in Medical Terminology, Anatomy & Physiology, and a certified coding course.10 years of experience in ICD coding and DRG validation audits of inpatient medical records in an acute care facility.Experience in using a computerized coding & abstracting database software and encoding/code-finder systems (e.g., 3M 360 Encompass/CAC & 3M Coding & Reimbursement System (CRS)).Working knowledge of CPT, HCPCs, and ICD9 coding principles.Demonstrate excellent customer service behavior and communication skills.Preferred Qualifications:AHIMA Certified Coding Specialist (CCS) or AAPC Certified Inpatient Coder (CIC).Fire Life Safety Training (LA City) if applicable.The hourly rate range for this position is $39.00 - $63.95. When extending an offer of employment, the University of Southern California considers factors such as the scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.Posted Date:
11/16/2023
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