Accurately audits hospital inpatient, ambulatory surgery, observation, and other outpatient encounters to support appropriate reimbursement, research, and compliance with federal and state regulations. Serves as a clinical coding subject matter expert and advises coding and clinical staff on documentation and coding issues.
Key responsibilities include:
- Auditing ICD-10-CM, ICD-10-PCS, and CPT-4 codes for outpatient, ambulatory surgery, observation, and complex inpatient cases
- Ensuring accurate APR-DRG, SOI/ROM, and POA assignment
- Serving in an advisory and educator role for coding specialists
- Communicating coding accuracy issues with hospital departments and management
- Assisting with coding queries and collaboration with CDI teams
- Researching new surgical procedures and technology
- Providing training to new employees
- Reporting coder quality and productivity rates
- Conducting focused audits as needed
- Performing coding corrections and other assigned projects
Requirements & Qualifications
Education and experience
- High school diploma or equivalent
- Formal ICD-10-CM, ICD-10-PCS, and CPT-4 training
- Associate's or bachelor's degree preferred; education may be considered in lieu of experience
- Minimum 2 years of ICD-10-CM/ICD-10-PCS coding and abstracting experience in a Level 1 Trauma hospital, or 4 years of inpatient hospital coding experience
- 2-3 years of ambulatory coding experience
- Certification in one of the following: CCS, RHIT, RHIA, or CIC
Knowledge and skills
- Strong knowledge of coding compliance standards and AHIMA ethical coding guidelines
- Ability to analyze documentation and coding issues using critical thinking
- Familiarity with CDI collaboration, query writing, and quality reporting
- Knowledge of PPCs, MHACs, PQIs, and related quality indicators
Benefits & Perks
- Compensation: $33.46 - $46.70 per hour
Location
Baltimore, Maryland, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago