Performs audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC CC) and procedure codes.
Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates. Draws on advanced ICD-10 coding expertise and clinical knowledge to substantiate conclusions.
U tilizes HMS proprietary auditing systems with a high level of proficiency to document audit determinations and rationale. Applies critical clinical review judgment to make coding validation determinations including sequencing ICD-10-CM, ICD-10-PCS procedural codes for inpatient claims.
Consistently achieves productivity and quality performance standards established by management.
Assists management with training new Coders or Clinical DRG Auditors to include daily monitoring, mentoring, feedback and education.
Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain RN license and coding certification
Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulation
