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Job Description




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University of Utah Job Description


Job Title: Coding Auditor
Job Code: 3066 Grade/FLSA: E/Non-Exempt
Updated By: Shealee Bennett - 12/20/2018 09:01:21 am

Job Summary

Under supervision of the coding manager, provides coding and compliance support to multi-specialty physicians, mid-level providers, support staff and administration. Auditor will monitor coding and billing activities to ensure activities performed are in compliance with applicable federal and state statutes/regulations.

Provide education and improvement of documentation to departments and staff to ensure accurate coding and billing.

Qualifications

American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) recognized certification such as: Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H), Certified Professional Coder-Payer (CPC-P), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician Based (CCS- P), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or other specialty certification indicated by the department, plus 4 years coding, clinical, or billing experience. Departments may prefer specific certifications over others.

Demonstrated human relations and effective communication skills also required; proficiency with medical terminology.

This position is not responsible for providing patient care.

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Disclaimer

This job description has been designed to indicate the general nature and level of work performed by employees within this classification.  It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Essential Functions

1. Reviews and audits professional coding and billing from multiple departments and entities of University Health Care.

2. Reports on the accuracy of procedure coding, E&M coding, ICD-10 coding and billing to ensure compliance with legal and procedural policies

3. Review billing processes for accuracy and process improvements

4. Identify inaccurate coding services; prepares reports of findings and meets with providers and medical office staff to provide education and training on accurate coding practices and compliance issues.

5. Assists in training personnel in correct documentation processes and coding guidelines.

6. Oversee on-going projects that are within the scope of this position

Problem Solving

Incumbent must have intricate knowledge of coding rules as outlined by CMS, AHA AMA. S/he must be able to identify areas or items which are not in compliance with the rules, present findings in a coherent and succinct format to diverse groups (e.g. physicians, nurses, administrators/directors coders, billers) and recommend appropriate changes to policies and procedures.

Comments

Work Environment and Level of Frequency typically required

Nearly Continuously: Office environment.

Physical Requirements and Level of Frequency that may be required

Nearly Continuously: Sitting, hearing, listening, talking.

Often: Repetitive hand motion (such as typing), walking. 

Seldom: Bending, reaching overhead.



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