Auditor

• Lead coding teams
• Train and mentor coders on correct ICD-CM and ICD-PCS guideline application
• Manage work queues daily, prioritizing and assigning inpatient accounts for coding within designated timelines
• Conduct prebill and retrospective audits of discharged inpatient records to validate coding and DRG assignments
• Document audit findings to improve CC/MCC capture, risk variable capture, HAC/PSI, HCC, and quality indicator validation
• Identify documentation, coding, reimbursement, and coding compliance issues and report trends to coding leadership
• Coordinate provider documentation queries for the Clinical Documentation Integrity team
• Consult and collaborate with clinical documentation specialists on coding and documentation practices
• Develop and maintain coding curriculum and training materials
• Develop educational programs for coding, clinical documentation, and medical staff, including yearly coding/DRG updates
• Assign ICD and ICD-PCS codes and DRGs for inpatient records, including major traumas and NICU records
• Verify DRGs, MCCs/CCs, HACs, and PSIs; select principal diagnoses and assign POA indicators and risk-adjustment diagnoses
• Review and respond to inpatient denials and assist with coding and clinical validation denials
• Assist management with coding issue resolution, process improvement, and HIM application system testing
• Participate in CDI-Coding Task Force and collaborative training with CDI, PFS, specialty areas, and Quality
• Perform other duties as assigned

Senior Health Information Management Inpatient Coding Auditor

• Coordinate and complete audit reviews
• Review audit work papers and reports completed by department staff
• Distribute reports to management
• Coordinate auditors' assignments
• Mentor and coach department staff
• Assist the department manager with workflow direction for risk management activities and special projects
• Plan and execute audits in accordance with professional auditing standards
• Perform or support audits focused on operational controls, asset safeguarding, and compliance
• Serve as in-charge auditor for complex audit reviews and/or cost reports
• Review account reconciliations performed by financial areas
• Analyze key processes, systems, and controls to determine effectiveness
• Communicate audit status and results to management, discuss deficiencies, and recommend corrective actions
• Prepare formal written work papers and reports documenting audit work and conclusions
• Assess subordinate auditors' desk reviews and provide on-the-job training
• Ensure audits comply with GAAP, GAAS, and Government Auditing Standards
• Coordinate assignments for timely completion within budget and departmental goals
• Direct day-to-day efforts of assigned audit staff through planning, training, leadership, and guidance
• Assist with developing and revising work instructions, forms, and procedures
• Maintain knowledge of applicable laws, regulations, and procedures through self-study, on-the-job training, seminars, and formal training programs
• Communicate with internal and external areas to ensure efficient task completion

Auditor jobs in South Carolina

Senior Health Information Management Inpatient Coding Auditor

Lead Medicare Cost Reporting Auditor