Coder Auditor - SCDNNJ MEDICAL RECORDS in Denville, NJ at Prime Healthcare

Date Posted: 5/16/2020

Job Snapshot

Job Description


The Coder Auditor reviews and analyzes documentation present in the medical record for both inpatient and outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software.  Coder Auditor finalizes the coding and abstracting of the medical record upon ensuring the assignment of International Classifications of Diseases, Ninth Revision (ICD-9-CM) or Tenth revision (ICD-10/PCS), Current Procedural Terminology (CPT), and Health Care Procedure Coding System (HCPCS), are accurate and supported by the clinical documentation of the respective medial record.  Holding a senior coding position, assumes primary responsibility for DRG validation/accuracy, primary role in assisting CDS and medical staff members with improving quality of clinical documentation.  Participates in chart review projects as assigned and other duties as needed.
The Outpatient Coder Auditor will concurrently review charts, including registration, authorization/ certification, nursing notes, physician orders, progress notes and reports/results to ensure that all codes captured and that the procedures performed match what was pre-authorized with the insurance company by the ordering physician offices. Outpatient Coder Auditor will review and analyze documentation present in the medical record for outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. Outpatient Coder Auditor will verify that information on the booking sheet and/or prescription is correct prior to scheduling the procedure. Outpatient Coder Auditor will educate physician’s offices as to the proper assignment of procedure codes for booking, scheduling and authorization purposes. Outpatient Coder Auditor will communicate concurrently with Insurance Verification team to obtain new authorizations as needed. Outpatient Coder Auditor supports clinical leaders/ assigned staff in charge reconciliation process on a regular basis. Outpatient Coder Auditor will participate in chart reviews and audits as well as other duties as assigned.


Required qualifications:
  • CCS is required.
  • Familiar with Hospital and Professional Coding, Infusion Injection Coding.
  • Thorough knowledge of ICD-10-CM, CPT, anatomy and physiology, medical terminology, APC's.Preferred qualifications:
  •  Registered Health Information Technician (R.H.I.T.), or Registered Health Information Administrator (R.H.I.A.).
  • One year of clinical experience in acute care setting preferred.
  • Basic computer experience required.
  • Use of an encoder software product for code assignment in an acute care setting required.
  • Computer data entry with 10-key preferred, with accurate typing speed of 35 wpm preferred.
  • Excellent written and verbal communication skills. Excellent critical thinking skills.
  •  We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.  EEO is the Law: