University of Maryland Medical System
Coding Compliance Auditor, Inpatient
University of Maryland Medical System, Baltimore, Maryland, United States, 21276
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Coding Compliance Auditor, Inpatient
role at
University of Maryland Medical System .
General Summary: Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems.
Principal Responsibilities Tasks
Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.
Audits ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, and observation visits for reimbursement, research and compliance with federal and state regulations.
Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc., utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment.
Serves in an advisory and educator role for Coding Specialists. Serves as communicator between Clinical Documentation Specialists and Coding. Researches new surgical procedures and technology. Provides training to new employees.
Reports coding quality accuracy rate for each coder and monitors productivity rate for each coder. Conducts specialized focused audits as needed.
Communicates with various departments within the hospitals regarding coding accuracy. Refers any problems to management timely, providing clear details. Assists coding specialists in writing appropriate coding queries, works collaboratively with CDI, understands Potentially Preventable Complications (PPC’s)/Maryland Hospital Acquired Conditions (MHAC’s), Prevention Quality Indicators (PQI’s) and their impact and other indicators as needed.
Complies with AHIMA standards of ethical coding and coding compliance guidelines.
Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager.
Education and Experience
High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training. Associate’s or Bachelor's degree. Education will be considered in lieu of experience.
Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience at a Level 1 Trauma hospital or four years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience.
One of the following certifications: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC).
Knowledge, Skills, and Abilities Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.
All your information will be kept confidential according to EEO guidelines.
Compensation Pay Range: $33.36 - $46.70
Benefits Review the 2024-2025 UMMS Benefits Guide.
Like many employers, UMMS is being targeted by cybercriminals impersonating our recruiters and offering fake job opportunities. We will never ask for banking details, personal identification, or payment via email or text. If you suspect fraud, please contact us at careers@umms.edu.
PandoLogic. Keywords: Regulatory Compliance Auditor, Location: Baltimore, MD - 21201
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Coding Compliance Auditor, Inpatient
role at
University of Maryland Medical System .
General Summary: Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems.
Principal Responsibilities Tasks
Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.
Audits ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, and observation visits for reimbursement, research and compliance with federal and state regulations.
Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc., utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment.
Serves in an advisory and educator role for Coding Specialists. Serves as communicator between Clinical Documentation Specialists and Coding. Researches new surgical procedures and technology. Provides training to new employees.
Reports coding quality accuracy rate for each coder and monitors productivity rate for each coder. Conducts specialized focused audits as needed.
Communicates with various departments within the hospitals regarding coding accuracy. Refers any problems to management timely, providing clear details. Assists coding specialists in writing appropriate coding queries, works collaboratively with CDI, understands Potentially Preventable Complications (PPC’s)/Maryland Hospital Acquired Conditions (MHAC’s), Prevention Quality Indicators (PQI’s) and their impact and other indicators as needed.
Complies with AHIMA standards of ethical coding and coding compliance guidelines.
Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager.
Education and Experience
High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training. Associate’s or Bachelor's degree. Education will be considered in lieu of experience.
Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience at a Level 1 Trauma hospital or four years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience.
One of the following certifications: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC).
Knowledge, Skills, and Abilities Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.
All your information will be kept confidential according to EEO guidelines.
Compensation Pay Range: $33.36 - $46.70
Benefits Review the 2024-2025 UMMS Benefits Guide.
Like many employers, UMMS is being targeted by cybercriminals impersonating our recruiters and offering fake job opportunities. We will never ask for banking details, personal identification, or payment via email or text. If you suspect fraud, please contact us at careers@umms.edu.
PandoLogic. Keywords: Regulatory Compliance Auditor, Location: Baltimore, MD - 21201
#J-18808-Ljbffr