Coding Quality Auditor

Provides audits and reviews patient charts, the corresponding ICD-9, CPT-4 codes, and charges for appropriateness. Provides reports to management of findings and recommendations for solutions. Identifies areas of improvement which will enhance internal controls and performance throughout Children’s Healthcare of Atlanta. Proactively supports the efforts that ensure safe patient care and services and promote a safe environment at Children's Healthcare of Atlanta. Works with management team to educate Coding staff on coding and documentation compliance.

•High school diploma or equivalent

•Registered Health Information Technologist (RHIT) , Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC), Certified Professional Compliance Officer (CPCO), Certified Coding Specialist (CCS), or Licensed Practical Nurse (LPN)

•No minimum experience required

•Associate's degree in Health Information Management or related field
•1 year of experience in auditing with a healthcare organization or insurance company

•Knowledge of diagnosis-related group and ambulatory payment classification regulations
•Demonstrated knowledge of InterQual Criteria and Medicaid and managed care rules and regulations
•Strong analytical, organizational, and communication skills
•Must be able to successfully pass the Basic Windows Skill Assessment at 80% or higher rating within 30 days of employment

1.Conducts chart audits for compliance assessment and establishes coding policy and procedure.
2.Prepares a report of findings for each audit along with an action plan.
3.Records and monitors corrections to the bill.
4.Assists in designing continued education to address deficiencies.
5.Plans and organizes work assignments to complete audits in an efficient manner.
6.Identifies problem situations or inadequate charge reconciliation procedures.
7.Clearly documents information to support findings and conclusions.
8.Keeps appropriate management personnel informed of any problems or unusual circumstances on a timely basis.
9.Facilitates improvement in the overall quality and completeness of medical records documentation.
10.Provides documentation education.