Westchester Medical Center Health Network
Network Practice Coder/Auditor
Westchester Medical Center Health Network, Valhalla, New York, United States, 10595
Ambulatory Practice Coder/Auditor Network—ON‑SITE
Job Summary: The Coder is responsible for auditing medical records, including applicable diagnoses and operative/diagnostic procedures in patient medical records, using the current International Classification of Diseases (ICD), Current Procedural Terminology (CPT) and Health Care Financing Administration Common Procedural Coding System (HCPCS). The Coder identifies opportunities for improvement and ensures compliance with coding and documentation guidelines. In addition, the Coder provides education and training to providers and other agency coders based on the findings of the medical records audits.
Responsibilities
Audit medical records for coding accuracy using the current HCPCS, ICD and CPT coding guidelines.
Identify patterns and opportunities requiring provider education; collaborate with providers and office staff to educate on proper coding and documentation.
Identify service‑specific/provider‑specific trends for education.
Conduct focused audits on specific services/specialties to identify root causes of coding/denials and provide feedback.
Maintain a log of findings and re‑reviews to ensure understanding and ongoing correctness.
Identify coding trends for the purpose of education to coding staff, physicians and APPs.
Provide education to physicians and APPs regarding proper documentation to support billing activities.
Keep abreast of payer rules regarding coding to assist with possible charge transformation rules.
Review edits in Cerner and SSI to identify additional documentation/coding/medical necessity trends for correction and education.
Work with the Clinisys team to flag possible coding issues.
Monitor coding E/M levels to identify trends requiring further education.
Other duties as assigned.
Qualifications & Requirements
Experience: Three to four years of experience in outpatient medical records coding in an ambulatory setting.
Education: High school or equivalency diploma (required). An Associate’s or Bachelor’s degree in health information management may substitute for one year of the required experience.
Licenses / Certifications
Current certification as a Certified Coding Specialist (CCS) or Certified Coding Specialist‑Physician Based (CCS‑P) through AHIMA, or as a Certified Professional Coder (CPC) through the American Academy of Professional Coders.
Other Qualifications • Thorough knowledge of HCPCS, CPT and ICD codes; medical terminology; principles of the medical record system and its operation; ability to understand and code medical records; effective communication skills (oral and written); strong computer proficiency (spreadsheets, word processing, email, database software); sound judgment, tact, discretion, initiative, accuracy; physical ability to perform essential duties; proficient in English.
#J-18808-Ljbffr
Responsibilities
Audit medical records for coding accuracy using the current HCPCS, ICD and CPT coding guidelines.
Identify patterns and opportunities requiring provider education; collaborate with providers and office staff to educate on proper coding and documentation.
Identify service‑specific/provider‑specific trends for education.
Conduct focused audits on specific services/specialties to identify root causes of coding/denials and provide feedback.
Maintain a log of findings and re‑reviews to ensure understanding and ongoing correctness.
Identify coding trends for the purpose of education to coding staff, physicians and APPs.
Provide education to physicians and APPs regarding proper documentation to support billing activities.
Keep abreast of payer rules regarding coding to assist with possible charge transformation rules.
Review edits in Cerner and SSI to identify additional documentation/coding/medical necessity trends for correction and education.
Work with the Clinisys team to flag possible coding issues.
Monitor coding E/M levels to identify trends requiring further education.
Other duties as assigned.
Qualifications & Requirements
Experience: Three to four years of experience in outpatient medical records coding in an ambulatory setting.
Education: High school or equivalency diploma (required). An Associate’s or Bachelor’s degree in health information management may substitute for one year of the required experience.
Licenses / Certifications
Current certification as a Certified Coding Specialist (CCS) or Certified Coding Specialist‑Physician Based (CCS‑P) through AHIMA, or as a Certified Professional Coder (CPC) through the American Academy of Professional Coders.
Other Qualifications • Thorough knowledge of HCPCS, CPT and ICD codes; medical terminology; principles of the medical record system and its operation; ability to understand and code medical records; effective communication skills (oral and written); strong computer proficiency (spreadsheets, word processing, email, database software); sound judgment, tact, discretion, initiative, accuracy; physical ability to perform essential duties; proficient in English.
#J-18808-Ljbffr