Auditor - Facility Inpatient

Job description STAR Medical Auditing Services is a boutique consulting firm that provides Health Information Management (HIM) and Clinical services to various organizations in the healthcare ecosystem across the U.S. We pride ourselves in providing high-quality services that are tailored to our clients’ specific needs, while creating joyful experiences along the way by treating everyone with respect and care. Must reside and be legal to work in the U.S.

Overview

Essential Duties and Responsibilities:

• Reviews medical records to identify diagnoses and PCS procedures relative to the patient’s encounter.
• Ensure all coding complies with the ethical coding standards/guidelines and regulatory requirements.
• Validate principal diagnosis and principal procedure, along with other diagnoses and procedures are selected using UHDDS definition. Ensures appropriate DRG assignment.
• Validate appropriate information from the medical record is abstracted based on the guidelines provided by the client and after a thorough review of the medical record.
• Make recommendations for ambiguous or conflicting documentation in the medical record using guidelines provided by the client which should have been queried.
• Communicates identified errors with thorough rationales including citing guidelines and sources
• Provide Educational feedback as necessary.
• Maintains strict confidentiality; adheres to all Health Insurance Portability and Accountability Act guidelines/regulations.

Education and/or Work Experience Requirements:

• Must have one of the following AHIMA/AAPC certifications: CPC, CCS.
• Extensive knowledge of medical terminology, anatomy and coding guidelines for ICD-10, PCS, etc.
• At least 3 years of recent auditing experience in:
• Facility Inpatient Auditing for Level II Trauma Center, Level I preferred.
• CPT Coding preferred but not required.
• PCS Coding.
• Compliant Query practices.
• Knowledge of current and developing issues, trends in medical coding procedures requirements, and be able to research as needed.
• Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures, and documentation including CMS guidelines.
• Proficient computer skills using MS-Word, Excel, Outlook, Internet Explorer, electronic medical records (EMR) systems including Epic, Meditech, Cerner, etc. along with 3M computer assisted coding program.
• Meet required client productivity standards and maintain a minimum of 97% accuracy.
• Self-sufficient with strong analytical and research skills.
• Responsible and responsive.
• Strong attention to detail.
• Excellent written and oral communication skills.
• Ability to meet deadlines.
• Must reside and be legal to work in the U.S.

Physical Requirements:

• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
• Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards

Segregation of Duties Every employee is responsible to perform their duties and responsibilities in accordance with STAR’s values, policies and procedures, including but not limited to, Segregation of Duties Principles, HIPAA Security and Privacy, and any other applicable laws, rules and regulations. Statement of Other Duties This document outlines the essential functions, requirements, and responsibilities of the position, and is not intended to be a complete list of all tasks and duties. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or by management. Job Type: Part-time Pay: $37.00 - $39.00 per hour Expected hours: 20 per week Benefits:

• 401(k)
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health savings account
• Paid time off
• Referral program
• Tuition reimbursement
• Work from home

Experience:

• recent Facility Inpatient auditing: 3 years (Required)

License/Certification:

• CPC or CCS credential (Required)

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