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Coding audit specialist

Beaumont Health

This is a Full-time position in Southfield, MI posted November 7, 2019.

Provide assurance of accurate and compliant coding to Beaumont Health management, executive leadership and the Audit and Compliance Committee of the Board of Directors through the conduct of internal coding audits. Make recommendations and provide advisory support to assist management in maintaining accurate coding practices.

Essential Duties: 1.

Conduct internal coding audits of professional (provider) and technical (facility) services to evaluate whether coded data can be validated in the medical record in accordance with the internal audit coding work plan. Includes audit of documentation, coding, and billing processes. Responsible for generation of results analysis and process improvement recommendations.

2.

Prepare audit reports that effectively communicate the results of completed audits and any necessary remediation to management.

3.

Follow up on management action plans implemented to address necessary remediation to ensure that underlying issues have been resolved.

4.

Support the Compliance and Enterprise Risk Management functions as requested with advisory support as it relates to coding, documentation requirements and risk areas.

5.

Support the Manager of Coding Audits in preparing the annual coding audit work plan identification of emerging risk areas for consideration for inclusion in the plan.

6.

Review, evaluate, interpret, and summarize rules, regulations and regulatory guidelines as required to perform coding audit and validate accuracy.

7.

Assist with development of coding compliance education materials and presentation of materials for; in-services and training on correct coding and documentation rules including application of rules.

8.

Executes special coding compliance audit projects as assigned by Management.

Assist with internal fact finding relative to coding compliance concerns and assist with evaluation of issues and auditing to establish level of risk as it relates to coding and documentation compliance.

9.

Research and respond to internal coding compliance queries/issues conducting research on regulatory and compliance issues. Provide guidance on correct coding, documentation.

Standard Qualification:
· Minimum Associate Degree Required.

· 3-5 years’ coding/auditing work experience in at least one of the following areas; professional, inpatient, facility coding and/or auditing. Work experience and coding skill in more than one area preferred.

· One of the following credentials required: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Professional Coder (CPC) or Certified Outpatient Coder (COC), Certified Inpatient Code (CIC) preferred.

Other Qualifications : Ability to perform complex coding audits with minimal supervision.

Proficient at researching complex coding issues and interpretation of coding rules and guidelines. Attention to detail including ability to accurately document and present summary findings of complex coding audits. Knowledge of MS office with proficiency Word and Excel. Highly skilled at communication with proficiency in articulating complex coding issues at all levels of the organization and externally when necessary.